Share This Article:
Short Report

Systemic Sarcoidosis Revealed by a Nasal Lesion: A Case Report

Abstract Full-Text HTML XML Download Download as PDF (Size:314KB) PP. 257-261
DOI: 10.4236/ijcm.2015.64032    2,644 Downloads   2,960 Views  

ABSTRACT

A 62-year-old man presented with bilateral nasal obstruction and recurrent epistaxis episodes. Physical examination revealed normal body temperature and free cervical lymph nodes areas. Nasal endoscopy found a congestive nasal mucosa associated to bilateral inferior turbinate hypertrophy with a granular aspect of the right inferior turbinate. The biological examination showed lymphopenia, inflammatory syndrome, high serum level of angiotensin-converting enzyme and β2 microglobulin. Tuberculin skin test and Quantiferon gold were negative. The nasal and accessory salivary gland biopsies revealed granulomatous giant cell lesions non-caseating evoking systemic sarcoidosis. Ziehl-Neelsen staining and Lowenstein culture were negative. The diagnosis was systemic sarcoidosis revealed by nasal localization. The systemic extension research was negative. The treatment was based on corticosteroids (1 mg/kg/day) and gradual degression doses associated to a local nasal corticosteroid. The outcome was favorable with improvement of nasal obstruction and disappearance of initial lesions. The follow-up was 2 years.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Mahfoudhi, M. , Khammassi, K. , Turki, S. and Salah, M. (2015) Systemic Sarcoidosis Revealed by a Nasal Lesion: A Case Report. International Journal of Clinical Medicine, 6, 257-261. doi: 10.4236/ijcm.2015.64032.

References

[1] Baughman, R.P., Lower, E.E. and du Bois, R.M. (2003) Sarcoidosis. Lancet, 361, 1111-1118.
http://dx.doi.org/10.1016/S0140-6736(03)12888-7
[2] Criado, E., Sanchez, M., Ramirez, J., Arguis, P., de Caralt, T.M., Perea, R.J., et al. (2010) Pulmonary Sarcoidosis: Typical and Atypical Manifestations at High-Resolution CT with Pathologic Correlation. Radiographics, 30, 1567-1586.
http://dx.doi.org/10.1148/rg.306105512
[3] Iannuzzi, M.C. and Fontana, J.R. (2011) Sarcoidosis: Clinical Presentation, Immunopathogenesis, and Therapeutics. JAMA, 305, 391-399.
http://dx.doi.org/10.1001/jama.2011.10
[4] Neville, E., Walker, A.N. and James, D.G. (1983) Prognostic Factors Predicting the Outcome of Sarcoidosis: An Analysis of 818 Patients. QJM, 52, 525-533.
[5] Khammassi, N., Kwas, H., Bayoudh, A., Abdelhedi, H., Zendah, I., Cherif, I., et al. (2014) Systemic Sarcoidosis Revealed by an Involvement of the Nasal Sinuses. La Tunisie Médicale, 92, 181-183.
[6] Mallis, A., Mastronikolis, N.S., Koumoundourou, D., Stathas, T. and Papadas, T.A. (2010) Sinonasal Sarcoidosis. A Case Report. European Review for Medical and Pharmacological Sciences, 14, 1097-1099.
[7] Dessouky, O.Y. (2008) Isolated Sinonasal Sarcoidosis with Intracranial Extension: Case Report. Acta Otorhinolaryngologica Italica, 28, 306-308.
[8] Kort, K.R., Cherif, F., Mokni, M., Bouraoui, S., Mnif, E., Sahtout, S., et al. (2006) Nasosinusal Sarcoidosis: 2 Cases. A Report of 2 Cases. La Tunisie Médicale, 84, 48-51.
[9] Morre, T.D., Hamels, K., Clement, P.A. and Bourgain, C. (1998) Nasal Mucosal Sarcoidosis: A Case Report. Acta Oto-Rhino-Laryngologica Belgica, 52, 75-77.
[10] Khachemoune, A. (2006) Papules and Plaques on the Nose. Lupus Pernio. American Family Physician, 73, 1431-1432.
[11] Meybeck, A., Just, N., Heurtebise, F., Chanez, P., Crampette, L., Darras, J., et al. (2004) Involvement of the Nasal Sinuses in Sarcoidosis. A Prospective Study of 63 Patients. Revue des Maladies Respiratoires, 21, 279-286.
http://dx.doi.org/10.1016/S0761-8425(04)71286-3
[12] Braun, J.J., Bourjat, P., Oster, J.P., Pauli, G., Quoix, E. and Gentine, A. (2001) Nasosinusal Sarcoidosis: 13 Cases. Annales d’Otolaryngologie et de Chirurgie Cervico-Faciale, 118, 238-244.
[13] Fergie, N., Jones, N.S. and Havlat, M.F. (1999) The Nasal Manifestations of Sarcoidosis: A Review and Report of Eight Cases. Journal of Laryngology Otology, 113, 893-898.
http://dx.doi.org/10.1017/S0022215100145529
[14] Hermet, M., le Guenno, G., Rieu, V., Philippe, P. and Ruivard, M. (2012) Nasosinusal and Cervical Sarcoidosis: A Case Series of Three Patients and Literature Review. La Revue de Médecine Interne, 33, 46-49.
http://dx.doi.org/10.1016/j.revmed.2011.04.002

  
comments powered by Disqus

Copyright © 2018 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.