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Abstract

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Article in Japanese

Case Report

A case of sarcoidosis associated with rheumatoid arthritis

Fumio Kurosakia  Masashi Bandoa  Tamiko Takemurab  Naoko Matoa  Hideaki Yamasawaa  Yoshinobu Eishic  Yukihiko Sugiyamaa 

aDivision of Pulmonary Medicine, Department of Medicine, Jichi Medical University
bDepartment of Pathology, Japanese Red Cross Medical Center
cDepartment of Human Pathology, Tokyo Medical and Dental University

ABSTRACT

A 46-year-old woman presented at a local hospital with polyarthralgia and dyspnea on exertion. She was referred to our hospital on suspicion of rheumatoid arthritis with interstitial pneumonia, according to her chest X-ray. Biopsy specimens obtained by video-assisted thoracoscopic surgery (VATS) and skin biopsy showed noncaseating epithelioid cell granulomas consistent with sarcoidosis. We therefore considered that this could be a case of polyarthralgia of sarcoidosis with articular involvement. Four years later she was diagnosed with rheumatoid arthritis because of articular erosion and atlanto-axial subluxation. We reviewed the earlier biopsy specimens obtained by VATS, which showed not only granulomas, but also follicular bronchiolitis. We therefore concluded that sarcoidosis and rheumatoid arthritis had already coexisted at that time. When articular involvement and interstitial pneumonia are found in patients with sarcoidosis, we should consider the possibility of coexistence of rheumatoid arthritis.

KEYWORDS

Sarcoidosis  Articular involvement  Rheumatoid arthritis  Interstitial pneumonia 

Received 12 Apr 2012 / Accepted 20 Jul 2012

AJRS, 2(2): 128-133, 2013

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