Sarcoidosis with involvement of the paranasal sinuses - a retrospective analysis of 12 biopsy-proven cases.
BACKGROUND
Extrapulmonary involvement by sarcoidosis is observed in about 30-40% of patients with sarcoidosis. Little is known about the frequency and clinical characteristics of sinonasal sarcoidosis.


METHODS
We retrospectively analyzed 12 cases of biopsy-proven sinonasal sarcoidosis. Patients were identified from a patient population of 1360 patients with sarcoidosis at the Outpatient Clinic for Sarcoidosis and Rare Lung Diseases at LungClinic Grosshansdorf, a tertiary care hospital for respiratory medicine.


RESULTS
The most frequent signs and symptoms were nasal polyps (4 cases), epistaxis (3 cases), nasal crusts (8 cases) and anosmia (5 cases). Pulmonary sarcoidosis of the patients was staged as stage I (n = 1) and stage II (n = 11) on chest radiographs. Spirometry was normal in 11 patients. 7 patients had a diffusion capacity of the lung for carbon monoxide of less than 90% of predicted. Other organs were affected in 8 patients. All patients received systemic corticosteroid treatment and most patients received topical steroids. 5 patients received steroid sparing agents. Repeated sinus surgery had to be performed in 4 patients.


CONCLUSIONS
Sinonasal involvement is a rare disease manifestation of sarcoidosis with a frequency slightly lower than 1% in our patient population. The clinical course of sinonasal sarcoidosis can be complicated by relapse despite systemic immunosuppressive treatment and repeated sinus surgery.
Pulmonary Research Institute at LungClinic Grosshansdorf, Airway Research Centre North, Member of the German Center for Lung Research, Grosshansdorf, Germany. a.kirsten@pulmoresearch.de.
Anne-Marie
AM
Kirsten
Henrik
H
Watz
Detlef
D
Kirsten
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D001706:Biopsy; D004844:Epistaxis / Q000209:etiology; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000473:pathology*; D000857:Olfaction Disorders / Q000209:etiology; D010254:Paranasal Sinus Diseases / Q000150:complications / Q000473:pathology* / Q000628:therapy*; D011859:Radiography; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000150:complications / Q000473:pathology* / Q000628:therapy*; D013256:Steroids / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D013256:Steroids