Fluorine-18 fluorodeoxyglucose with positron emission tomography revealed bone marrow involvement in sarcoidosis patients with anaemia.

BACKGROUND

Anaemia occurs in 13-28% of sarcoidosis patients. It is associated with bone marrow infiltration by epitheliod granulomas in about 50% of cases, but its pathophysiology remains unclear.

OBJECTIVES

It was the aim of this study to describe a series of sarcoidosis patients with and without anaemia who underwent metabolic imaging with fluorine-18 fluorodeoxyglucose with positron emission tomography ((18)F-FDG PET).

METHODS

The files of 3 sarcoidosis patients who exhibited anaemia and underwent metabolic imaging with (18)F-FDG PET were reviewed in comparison with those of all sarcoidosis patients (n = 7) who underwent (18)F-FDG PET during the same period of time.

RESULTS

In the 3 cases, symptomatic anaemia was associated with bone marrow sarcoidosis as attested by (18)F-FDG PET and confirmed by bone marrow biopsy. This observation is strengthened by the lack of bone marrow hypermetabolism by PET scan in the 7 control patients. Corticosteroids dramatically improved anaemia in 2 cases which correlated with a dramatic decrease in bone marrow glucose uptake. In contrast, there was a moderate increase in haemoglobin level in the third case and no change in metabolic imaging.

CONCLUSION

Whole-body (18)F-FDG PET imaging should be considered in sarcoidosis patients with symptomatic anaemia. It can noninvasively suggest bone marrow involvement, indicate sarcoidosis treatment and monitor its efficiency.