title: [Polyarthralgia as an initial symptom of sarcoidosis].
abstract: A 39 year-old patient consulted his family doctor due to migratory polyarthralgia, with C-reactive protein 7.99mg/dl, ESR 89mm and normal anti-streptolysin O (ASO). A sample was taken for analysis in the Rheumatology Clinic: ACE 72 IU, with normal rheumatoid factor, C-reactive protein and ASO; HLA non-specific. Chest X-ray showed an increased pulmonary interstitial pattern, and his chest-CT showed multiple bilateral pulmonary nodules and mediastinal lymph nodes. A differential diagnosis of lymphoproliferative process was considered. A gallium scintigraphy was performed with no relevant findings. The patient was referred to Thoracic Surgery for a lymph node biopsy by mediastinoscopy, which showed a non-necrotizing granulomatous lymphadenitis consistent with a sarcoidosis. Treatment with prednisone and anti-osteoporosis drugs was started and the patient was evaluated at four months with a new chest X-ray. There was a clinical and radiological remission therefore it was decided to gradually reduce the corticosteroid therapy.
authors.affiliation: Medicina de Familia y Comunitaria, Centro de Salud Delicias Sur, Zaragoza, España. Electronic address: nuriarequeno@gmail.com.
authors.forename: M N
authors.initials: MN
authors.lastname: Requeno-Jarabo
authors.forename: R
authors.initials: R
authors.lastname: Amorós-García
authors.forename: I I
authors.initials: II
authors.lastname: Murillo-Díaz de Cerio
authors.forename: A
authors.initials: A
authors.lastname: Antoñanzas-Lombarte
mesh_terms: D000328:Adult; D018771:Arthralgia / Q000209:etiology*; D006801:Humans; D008297:Male; D012507:Sarcoidosis / Q000150:complications* / Q000175:diagnosis*
keywords: Arthralgia; Artralgia; Lymph nodes; Nódulos linfáticos; Sarcoidosis