Handa Tomohiro, Nagai Sonoko, Ito Isao, Shigematsu Michio, Hamada Kunio, Kitaichi Masanori, Ohta Kosuke, Izumi Takateru, Mishima Michiaki
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, and Department of Internal Medicine, Chitose City Hospital, Hokkaido, Japan.
Intern Med. 2005 Dec;44(12):1269-75. doi: 10.2169/internalmedicine.44.1269.
A 22-year-old Japanese man was found to have bilateral hilar lymphadenopathy (BHL), and was diagnosed with sarcoidosis in 1995. He was followed without treatment until 2002, when a bone fracture due to osseous sarcoidosis was found in his left thumb. Despite systemic treatment with corticosteroid and methotrexate, a new bone lesion developed in his right foot and his right middle finger was fractured. The patient also suffered multiple organ involvements including brain and muscle lesions. This is the first report of a sarcoidosis patient who presented with BHL, and developed bone fractures after a long stable period of more than 5 years.