Clinical features and diagnostic evaluation of 83 biopsy-proven sarcoid uveitis cases
AimsTo determine the clinical features of patients with uveitis with biopsy-proven sarcoidosis, document differences in these features according to ethnicity, age and sex, and assess the diagnostic value of biochemical and imaging examinations.MethodsRetrospective study of 83 biopsy-proven sarcoid u...
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| Veröffentlicht in: | British journal of ophthalmology 2015-10, Vol.99 (10), p.1372-1376 |
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| creator | Febvay, Camille Kodjikian, Laurent Maucort-Boulch, Delphine Perard, Laurent Iwaz, Jean Jamilloux, Yvan Broussolle, Christiane Burillon, Carole Seve, Pascal |
| description | AimsTo determine the clinical features of patients with uveitis with biopsy-proven sarcoidosis, document differences in these features according to ethnicity, age and sex, and assess the diagnostic value of biochemical and imaging examinations.MethodsRetrospective study of 83 biopsy-proven sarcoid uveitis cases seen at two Departments of Internal Medicine and two Departments of Ophthalmology between April 2004 and March 2014.ResultsCaucasian patients presented with uveitis at a later age than non-Caucasian (58 years vs 41 years; p=0.001) and had more often a chronic form (78.3% vs 43.8%; p=0.01). Women had higher rates of chronic macular oedema than men (48.3% vs 14.3%; p=0.01). There were no statistically significant differences between patients aged ≤50 years and patients aged >50 years. ACE levels were high (>62 U/L) in 61.7% and lysozyme levels high (>16.7 mg/L) in 83.9% of tested patients. Chest X-rays and CTs were suggestive of sarcoidosis in 62.8% and 91.2% of cases, respectively. Among 21 patients with positive tomography and negative X-rays, 13 were Caucasian women >50 years. Endoscopic ultrasound-guided fine-needle aspiration of intrathoracic nodes contributed to the diagnosis in 7 patients with normal labial salivary gland and transbronchial biopsies. Any of the enzyme tests together with any of the imaging tests identified 100% of the patients.ConclusionsIn this largest European series of biopsy-proven sarcoidosis to date, the outstanding diagnostic ability of enzyme test plus imaging test couple suggests that the recourse to invasive procedures should be limited to patients with ocular involvement that would justify systemic treatments. |
| doi_str_mv | 10.1136/bjophthalmol-2014-306353 |
| format | Article |
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Women had higher rates of chronic macular oedema than men (48.3% vs 14.3%; p=0.01). There were no statistically significant differences between patients aged ≤50 years and patients aged >50 years. ACE levels were high (>62 U/L) in 61.7% and lysozyme levels high (>16.7 mg/L) in 83.9% of tested patients. Chest X-rays and CTs were suggestive of sarcoidosis in 62.8% and 91.2% of cases, respectively. Among 21 patients with positive tomography and negative X-rays, 13 were Caucasian women >50 years. Endoscopic ultrasound-guided fine-needle aspiration of intrathoracic nodes contributed to the diagnosis in 7 patients with normal labial salivary gland and transbronchial biopsies. Any of the enzyme tests together with any of the imaging tests identified 100% of the patients.ConclusionsIn this largest European series of biopsy-proven sarcoidosis to date, the outstanding diagnostic ability of enzyme test plus imaging test couple suggests that the recourse to invasive procedures should be limited to patients with ocular involvement that would justify systemic treatments.</description><identifier>ISSN: 0007-1161</identifier><identifier>EISSN: 1468-2079</identifier><identifier>DOI: 10.1136/bjophthalmol-2014-306353</identifier><identifier>PMID: 25837608</identifier><identifier>CODEN: BJOPAL</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biopsy, Fine-Needle - methods ; Diagnosis, Differential ; Diagnostic tests ; Disease ; Family medical history ; Female ; Humans ; Life Sciences ; Lymphatic system ; Male ; Medical imaging ; Middle Aged ; Radiography, Thoracic ; Retrospective Studies ; Salivary Glands, Minor - pathology ; Sarcoidosis ; Sarcoidosis, Pulmonary - complications ; Sarcoidosis, Pulmonary - diagnosis ; Studies ; Tomography, X-Ray Computed ; Uveitis - etiology ; Uveitis - pathology ; Uveitis - physiopathology ; Vision, Ocular ; White people ; Womens health ; Young Adult</subject><ispartof>British journal of ophthalmology, 2015-10, Vol.99 (10), p.1372-1376</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Copyright: 2015 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b557t-79db32a639277f6d2dc544237a2847bc8e9946b497d0a5abfab2a961715db49a3</citedby><cites>FETCH-LOGICAL-b557t-79db32a639277f6d2dc544237a2847bc8e9946b497d0a5abfab2a961715db49a3</cites><orcidid>0000-0001-5249-3650 ; 0000-0003-0042-7787</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bjo.bmj.com/content/99/10/1372.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://bjo.bmj.com/content/99/10/1372.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,230,314,780,784,885,3196,23571,27924,27925,77600,77631</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25837608$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://univ-lyon1.hal.science/hal-02044752$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Febvay, Camille</creatorcontrib><creatorcontrib>Kodjikian, Laurent</creatorcontrib><creatorcontrib>Maucort-Boulch, Delphine</creatorcontrib><creatorcontrib>Perard, Laurent</creatorcontrib><creatorcontrib>Iwaz, Jean</creatorcontrib><creatorcontrib>Jamilloux, Yvan</creatorcontrib><creatorcontrib>Broussolle, Christiane</creatorcontrib><creatorcontrib>Burillon, Carole</creatorcontrib><creatorcontrib>Seve, Pascal</creatorcontrib><title>Clinical features and diagnostic evaluation of 83 biopsy-proven sarcoid uveitis cases</title><title>British journal of ophthalmology</title><addtitle>Br J Ophthalmol</addtitle><description>AimsTo determine the clinical features of patients with uveitis with biopsy-proven sarcoidosis, document differences in these features according to ethnicity, age and sex, and assess the diagnostic value of biochemical and imaging examinations.MethodsRetrospective study of 83 biopsy-proven sarcoid uveitis cases seen at two Departments of Internal Medicine and two Departments of Ophthalmology between April 2004 and March 2014.ResultsCaucasian patients presented with uveitis at a later age than non-Caucasian (58 years vs 41 years; p=0.001) and had more often a chronic form (78.3% vs 43.8%; p=0.01). Women had higher rates of chronic macular oedema than men (48.3% vs 14.3%; p=0.01). There were no statistically significant differences between patients aged ≤50 years and patients aged >50 years. ACE levels were high (>62 U/L) in 61.7% and lysozyme levels high (>16.7 mg/L) in 83.9% of tested patients. Chest X-rays and CTs were suggestive of sarcoidosis in 62.8% and 91.2% of cases, respectively. Among 21 patients with positive tomography and negative X-rays, 13 were Caucasian women >50 years. Endoscopic ultrasound-guided fine-needle aspiration of intrathoracic nodes contributed to the diagnosis in 7 patients with normal labial salivary gland and transbronchial biopsies. Any of the enzyme tests together with any of the imaging tests identified 100% of the patients.ConclusionsIn this largest European series of biopsy-proven sarcoidosis to date, the outstanding diagnostic ability of enzyme test plus imaging test couple suggests that the recourse to invasive procedures should be limited to patients with ocular involvement that would justify systemic treatments.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biopsy, Fine-Needle - methods</subject><subject>Diagnosis, Differential</subject><subject>Diagnostic tests</subject><subject>Disease</subject><subject>Family medical history</subject><subject>Female</subject><subject>Humans</subject><subject>Life Sciences</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Middle Aged</subject><subject>Radiography, Thoracic</subject><subject>Retrospective Studies</subject><subject>Salivary Glands, Minor - pathology</subject><subject>Sarcoidosis</subject><subject>Sarcoidosis, Pulmonary - complications</subject><subject>Sarcoidosis, Pulmonary - diagnosis</subject><subject>Studies</subject><subject>Tomography, X-Ray Computed</subject><subject>Uveitis - etiology</subject><subject>Uveitis - pathology</subject><subject>Uveitis - physiopathology</subject><subject>Vision, Ocular</subject><subject>White people</subject><subject>Womens health</subject><subject>Young Adult</subject><issn>0007-1161</issn><issn>1468-2079</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkc1O3DAUha0KVKbQV0CW2NBFqP_tLNEIOpVGYlPW1nXsgEdJPMTJSLx9PQpFFStWlo--e3yuD0KYkhtKufrpdmn_PD1D16euYoSKihPFJf-CVlQoUyRdn6AVIURXlCp6hr7lvCtXpqj-is6YNFwrYlbocd3FITbQ4TbANI8hYxg89hGehpSn2OBwgG6GKaYBpxYbjl1M-_xa7cd0CAPOMDYpejwfQpxixg3kkC_QaQtdDt_fznP0eH_3Z72ptg-_fq9vt5WTUk-Vrr3jDBSvmdat8sw3UgjGNTAjtGtMqGuhnKi1JyDBteAY1GUFKn1RgZ-jH4tv-Qq7H2MP46tNEO3mdmuPGmFECC3ZgRb2emFL8Jc55Mn2MTeh62AIac62uKqaCymP6NUHdJfmcSibFEqbkoAaViizUM2Ych5D-56AEnusyf5fkz3WZJeayujl2wOz64N_H_zXSwH4Arh-93nbv5CCoWQ</recordid><startdate>20151001</startdate><enddate>20151001</enddate><creator>Febvay, Camille</creator><creator>Kodjikian, Laurent</creator><creator>Maucort-Boulch, Delphine</creator><creator>Perard, Laurent</creator><creator>Iwaz, Jean</creator><creator>Jamilloux, Yvan</creator><creator>Broussolle, Christiane</creator><creator>Burillon, Carole</creator><creator>Seve, Pascal</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0001-5249-3650</orcidid><orcidid>https://orcid.org/0000-0003-0042-7787</orcidid></search><sort><creationdate>20151001</creationdate><title>Clinical features and diagnostic evaluation of 83 biopsy-proven sarcoid uveitis cases</title><author>Febvay, Camille ; 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p=0.001) and had more often a chronic form (78.3% vs 43.8%; p=0.01). Women had higher rates of chronic macular oedema than men (48.3% vs 14.3%; p=0.01). There were no statistically significant differences between patients aged ≤50 years and patients aged >50 years. ACE levels were high (>62 U/L) in 61.7% and lysozyme levels high (>16.7 mg/L) in 83.9% of tested patients. Chest X-rays and CTs were suggestive of sarcoidosis in 62.8% and 91.2% of cases, respectively. Among 21 patients with positive tomography and negative X-rays, 13 were Caucasian women >50 years. Endoscopic ultrasound-guided fine-needle aspiration of intrathoracic nodes contributed to the diagnosis in 7 patients with normal labial salivary gland and transbronchial biopsies. Any of the enzyme tests together with any of the imaging tests identified 100% of the patients.ConclusionsIn this largest European series of biopsy-proven sarcoidosis to date, the outstanding diagnostic ability of enzyme test plus imaging test couple suggests that the recourse to invasive procedures should be limited to patients with ocular involvement that would justify systemic treatments.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>25837608</pmid><doi>10.1136/bjophthalmol-2014-306353</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0001-5249-3650</orcidid><orcidid>https://orcid.org/0000-0003-0042-7787</orcidid></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Biopsy, Fine-Needle - methods Diagnosis, Differential Diagnostic tests Disease Family medical history Female Humans Life Sciences Lymphatic system Male Medical imaging Middle Aged Radiography, Thoracic Retrospective Studies Salivary Glands, Minor - pathology Sarcoidosis Sarcoidosis, Pulmonary - complications Sarcoidosis, Pulmonary - diagnosis Studies Tomography, X-Ray Computed Uveitis - etiology Uveitis - pathology Uveitis - physiopathology Vision, Ocular White people Womens health Young Adult |
| title | Clinical features and diagnostic evaluation of 83 biopsy-proven sarcoid uveitis cases |
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