Synthetic pharmacotherapy for pulmonary sarcoidosis.
Synthetic pharmacotherapy for pulmonary sarcoidosis. Expert Opin Pharmacother. 2019 May 15;:1-8 Authors: Llabres M, Brito-Zerón P, Ramos-Casals M, Sellares J Abstract INTRODUCTION: Sarcoidosis is a granulomatous systemic disease of unknown cause where the lungs are the most frequently affected. Therapeutic management of the disease is challenging as clinical presentation and prognosis are very heterogeneous. Areas covered: This review summarizes the current knowledge of synthetic therapies for pulmonary sarcoidosis. The most commonly used medication for the treatment of sarcoidosis with lung involvement are glucocorticoids. Nevertheless, not all patients reach an acceptable response or tolerate them and the use of second-line treatments like immunosuppressive agents are necessary. Other kind of drugs could be used but there is no solid evidence and most of them are currently under investigation. Expert opinion: The majority of patients with pulmonary sarcoidosis do not require treatment and their sarcoidotic lung lesions could regress. However, it is important to treat the disease in those cases that could develop organ failure. Although the number of studies of therapies for pulmonary sarcoidosis have increased in recent years, the information available is still limited and there is no consensus on how to monitor the activity of the disease. PMID: 31090462 [PubMed - as supplied by publisher]
DiscussionGiven the multiorgan system potential adverse side effects of prednisone, proving noninferiority of an alternate regimen would be sufficient to make the alternative compare favorably to standard dose steroids. This is the first ever clinical trial in cardiac sarcoidosis and thus in addition to the listed goals of the trial, we will also establish a multi-center, multinational cardiac sarcoidosis clinical trials network. Such a collaborative infrastructure will enable a new era of high quality data to guide physicians when treating cardiac sarcoidosis patients.
Conclusion:18F-FDG PET/CT improved imaging and detection of pulmonary involvement and through TLG value revealed the deleterious smoking effect. The fact that TLG neither detected patients with clinical symptoms and functional impairment nor identified those requiring treatment once again confirms that in pulmonary sarcoidosis the link between activity, severity and decision to treat still eludes us. PMID: 31626563 [PubMed - as supplied by publisher]
We report a case of a 50-year-old woman treated with anti–PD-1 inhibition for metastatic melanoma. During treatment, extensive and transient histopathologically confirmed sarcoid-like reaction was detected in multiple organ systems and at different time points using 18F-FDG PET/CT imaging. Immune-related adverse events during anti-PD-1/PD-L1 antibody treatment are increasingly being reported. This case report emphasizes the broad spectrum of possible presentations of sarcoid-like reaction detected by 18F-FDG PET/CT and its evolution in time. For the clinician, awareness of these immune-related adverse events helps to...
Conclusion. 18F-FDG PET/CT imaging is a noninvasive imaging technique that can be crucial in the diagnosis of sarcoidosis of the spinal cord and help avoid unnecessary procedures. Level of Evidence: 4
Publication date: Available online 16 October 2019Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): R. Ramanan, T. Fancourt, S. Berlangieri, A. Grigg
We report a similar new case strongly suggesting a specific effect of this drug combination. PATIENTS AND METHODS: A 58-year-old man bearing 20-year-old tattoos was treated with dabrafenib and trametinib for advanced melanoma. A painful erythematous swelling appeared on all the patient's tattoos two months later, while his general tolerance of the treatment was poor. Skin biopsy demonstrated perivascular lympho-histiocytic infiltrate without granuloma, but with prominent pigment-loaded macrophages. Inflammatory signs quickly regressed after drug discontinuation. DISCUSSION: Great similarity exists between this ne...
DEAR MAYO CLINIC: I recently was diagnosed with sarcoidosis, but I don't currently have symptoms. What causes sarcoidosis? Could it go away on its own? What should I be on the lookout for as far as symptoms that may develop? ANSWER: Sarcoidosis is an inflammatory disease characterized by the formation of tiny collections of inflammatory [...]
ConclusionsGiven the clear advantages of cervical diagnosis in terms of invasiveness and economy compared to mediastinal alternatives, it is suggested that where the expertise for core biopsy of normal sized cervical lymph nodes is readily available, the technique may be considered as a first line investigation for the diagnosis of sarcoidosis.
Publication date: Available online 11 October 2019Source: Joint Bone SpineAuthor(s): Manuel Rubio-Rivas, Jonathan Franco, Xavier CorbellaAbstractObjectives: Just a few series of Löfgren’s syndrome have been reported. Our aim was to describe the epidemiology and clinical profile of sarcoidosis patients presenting with Löfgren’s syndrome vs. non-Löfgren’s syndrome.Methods: Retrospective cohort study of 691 consecutive patients with sarcoidosis diagnosed at the Bellvitge University Hospital in Barcelona, Spain, between 1976 and 2018.Results: 309 patients (44.7%) were diagnosed with Löfgre...