Raportim rasti: sarkoidozё qё imiton artritin reumatoid apo bashkekzistencё e tё dyja diagnozave
DOI:
https://doi.org/10.55312/op.vi2.6144Abstract
Hyrje: Artriti reumatoid është një nga sëmundjet reumatizmale autoimune më të shpeshta në praktikën klinike. Pavarësisht kritereve të mirëpërcaktuara të diagnostikimit, duhet bërë një diagnozë diferenciale me patologji të tjera që e imitojnë. Një ndër to është dhe sarkoidoza. Prezantimi i rastit: Një paciente 45 vjeç e diagnostikuar prej një viti me artrit reumatoid seropozitiv me dhimbje inflamatore të artikulacioneve të vogla të duarve me FR lehtësisht pozitiv, ANA pozitiv i lehtë, antiCCP negative nën mjekim me methotrexate 10 mg/javë, prednisone 5 mg/ditë, paraqitet në qendrën tonë për shkak të cervikobrakialgisë dexter. Iu rekomandua MRI kolone cervikale, ku përveç prolabimit diskal C4-C5 me ngushtim të neuroforaminës dexter, u evidentua prania e limfadenopatisë cervikale. Pas disa ekzaminimeve imazherike shtesë u konstatua limfadenopati e gjeneralizuar dhe me biopsi të limfonodulit u konfirmua diagnoza e sarkoidozës. Pas fillimit të trajtimit të sarkoidozës pacientja pati përmirësim të dukshëm të klinikës dhe testeve inflamatore. U gjendëm përpara një pikëpyetjeve nëse kemi të bëjmë me rastin e një sarkoidoze që imiton artritin apo bashkekzistencë të të dyja diagnozave. Konkluzioni: Pavarësisht plotësimit të kritereve për vendosjen e diagnozës së artritit rheumatoid, mjeku reumatolog duhet të bëjë diagnozë diferenciale me sëmundje të tjera të ngjashme në klinikë, teste inflamatore dhe që mund të japin rezultate lehtësisht positive të FR, ANA.Keywords:
sarkoidozë, artrit reumatoid, limfadenopati.Downloads
References
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Aletaha D, Neogi T, Silman AJ, et al 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/ European League Against Rheumatism collaborative initiative, Annals of the Rheumatic Diseases, 2010;69:1580-1588.
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Mackenzie, A H. “Differential diagnosis of rheumatoid arthritis.” The American journal of medicine vol. 85, 4A (1988): 2-11.
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Smolen, Josef S et al. “EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update.”, Annals of the rheumatic diseases vol. 79, 6 (2020): 685-699.
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Gary S. Firestein, Ralph C. Budd et al, Firestein and Kelleys textbook of rheumatology, 11th edition, Elsevier, 2021: 1247-1253.
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Gökten DB, Mercan R., Sarcoidosis from the Perspective of Rheumatology: Three Years of Experience, Namik Kemal Med J. 2024 Mar; 12(1):1-7.
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Soto-Gomez, Natalia et al. “Diagnosis and Management of Sarcoidosis.” American family physician vol. 93,10 (2016): 840-8.
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Hasbani GE, Uthman I, Jawad AS. Musculoskeletal Manifestations of Sarcoidosis. Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders. 2022;15
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Sweiss, Nadera J et al. “Rheumatologic manifestations of sarcoidosis.” Seminars in respiratory and critical care medicine vol. 31,4 (2010): 463-73.
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Neves, F.S., Pereira, I.A., Sztajnbok, F. et al. Sarcoidosis: a general overview. Adv Rheumatol 64, 57 (2024).
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Baughman, Robert P et al. “ERS clinical practice guidelines on treatment of sarcoidosis.” The European respiratory journal vol. 58,6 2004079. 16 Dec. 2021
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Kobak, Şenol et al. “Co-occurrence of rheumatoid arthritis and sarcoidosis.” BMJ case reports vol.
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bcr2014208803. 6 Jul. 2015
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Torralba, Karina D, and Francisco P Quismorio Jr. “Sarcoid arthritis: a review of clinical features, pathology and therapy.” Sarcoidosis, vasculitis, and diffuse lung diseases: official journal of WASOG vol. 20, 2 (2003): 95-103.
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Oreskes, Irwin et al. Changes in rheumatoid factor activity during the course of sarcoidosis, TheAmerican Journal of Medicine, Volume 44, Issue 1, 60 – 67.
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Crouser, Elliott D et al. “Diagnosis and Detection of Sarcoidosis. An Official American ThoracicSociety Clinical Practice Guideline.” American journal of respiratory and critical care medicine vol. 201,8 (2020): e26-e51.
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Terence Yeung, Adrian Grebowicz, Tatiana Nevskaya, Sulman Zahid, Janet E Pope, Joint involvement in sarcoidosis: systematic review and meta-analysis of prevalence, clinical pattern and outcome, Rheumatology, 63, 7, 2024; 1803-1814.
References
Aletaha D, Neogi T, Silman AJ, et al 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/ European League Against Rheumatism collaborative initiative, Annals of the Rheumatic Diseases, 2010;69:1580-1588.
Mackenzie, A H. “Differential diagnosis of rheumatoid arthritis.” The American journal of medicine vol. 85, 4A (1988): 2-11.
Smolen, Josef S et al. “EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update.”, Annals of the rheumatic diseases vol. 79, 6 (2020): 685-699.
Gary S. Firestein, Ralph C. Budd et al, Firestein and Kelleys textbook of rheumatology, 11th edition, Elsevier, 2021: 1247-1253.
Gökten DB, Mercan R., Sarcoidosis from the Perspective of Rheumatology: Three Years of Experience, Namik Kemal Med J. 2024 Mar; 12(1):1-7.
Soto-Gomez, Natalia et al. “Diagnosis and Management of Sarcoidosis.” American family physician vol. 93,10 (2016): 840-8.
Hasbani GE, Uthman I, Jawad AS. Musculoskeletal Manifestations of Sarcoidosis. Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders. 2022;15
Sweiss, Nadera J et al. “Rheumatologic manifestations of sarcoidosis.” Seminars in respiratory and critical care medicine vol. 31,4 (2010): 463-73.
Neves, F.S., Pereira, I.A., Sztajnbok, F. et al. Sarcoidosis: a general overview. Adv Rheumatol 64, 57 (2024).
Baughman, Robert P et al. “ERS clinical practice guidelines on treatment of sarcoidosis.” The European respiratory journal vol. 58,6 2004079. 16 Dec. 2021
Kobak, Şenol et al. “Co-occurrence of rheumatoid arthritis and sarcoidosis.” BMJ case reports vol.
bcr2014208803. 6 Jul. 2015
Torralba, Karina D, and Francisco P Quismorio Jr. “Sarcoid arthritis: a review of clinical features, pathology and therapy.” Sarcoidosis, vasculitis, and diffuse lung diseases: official journal of WASOG vol. 20, 2 (2003): 95-103.
Oreskes, Irwin et al. Changes in rheumatoid factor activity during the course of sarcoidosis, TheAmerican Journal of Medicine, Volume 44, Issue 1, 60 – 67.
Crouser, Elliott D et al. “Diagnosis and Detection of Sarcoidosis. An Official American ThoracicSociety Clinical Practice Guideline.” American journal of respiratory and critical care medicine vol. 201,8 (2020): e26-e51.
Terence Yeung, Adrian Grebowicz, Tatiana Nevskaya, Sulman Zahid, Janet E Pope, Joint involvement in sarcoidosis: systematic review and meta-analysis of prevalence, clinical pattern and outcome, Rheumatology, 63, 7, 2024; 1803-1814.
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