EP22 A manifestation of severe sarcoid arthropathy in the distal interphalangeal joint

Rajiv Ark

doi:10.1093/rap/rkaa052.021

Abstract

In 2011 a gentleman in his 50s presented with nasal blockage and bloody discharge. He was diagnosed with sarcoidosis and after 9 years of failed strategies to control his disease, he developed dactylitis. X-ray of the hands showed severe arthropathy in the distal interphalangeal joints. This case demonstrates an uncommon extrapulmonary manifestation of sarcoidosis. Although most of his follow up was with a respiratory clinic, his main symptoms were not due to interstitial lung disease, highlighting the importance of a multidisciplinary approach. To reduce the need for steroids, several DMARDs were tried illustrating that there are limited treatment options.

Highlights

Case report - Introduction: In 2011 a gentleman in his 50s presented with nasal blockage and bloody discharge
There was a recurrence of his nasal discharge; steroids were increased again but he developed symptoms of muscle weakness from long term steroid use
He was referred to an interstitial lung disease clinic at a tertiary centre where he was investigated for cardiac sarcoidosis with MRI due to ventricular ectopics

Summary

Introduction

Case report - Introduction: In 2011 a gentleman in his 50s presented with nasal blockage and bloody discharge. MRI brain imaging revealed the presence of extensive neurosarcoidosis, and the neurocognitive improvement with treatment of a TNF inhibitor, suggested that the underlying pathology was sarcoidosis. This case highlights the importance of a PET scan in demonstrating multi-system involvement in sarcoidosis. EP22 A MANIFESTATION OF SEVERE SARCOID ARTHROPATHY IN THE DISTAL INTERPHALANGEAL JOINT

Results

Conclusion