Bouchut Arthur, Lhote Raphael, Maksud Philippe, Ben Salem Thouraya, Fustier Anne, Moyon Quentin, Haroche Julien, Soussan Michael, Mathian Alexis, Hie Miguel, Amoura Zahir, Cohen Aubart Fleur
Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Service de Médecine Interne 2, Centre National de Référence Maladies Systémiques Rares et Histiocytoses, Hôpital Pitié-Salpêtrière, Paris, France.
Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Service de Médecine Nucléaire, Hôpital Pitié-Salpêtrière, Paris, France.
Rheumatology (Oxford). 2025 Feb 1;64(2):607-613. doi: 10.1093/rheumatology/keae019.
Sarcoidosis is a multisystemic granulomatosis diagnosed mainly in young adults. 18F-fluorodeoxyglucose (18F-FDG) PET/CT is useful in sarcoidosis cases to search for a biopsiable site or assess disease activity.18F-FDG PET/CT can reveal bone hypermetabolism in sarcoidosis patients, even in the absence of osteoarticular symptoms. The aim of this study was to describe metabolic bone involvement in sarcoidosis patients and to evaluate its prognostic impact.
This was an observational, comparative, retrospective, monocentric study. Inclusion criteria were a confirmed diagnosis of sarcoidosis according to the World Association of Sarcoidosis and Other Granulomatous Diseases (WASOG) criteria and at least one 18F-FDG PET/CT scan during follow-up. Metabolic bone involvement of sarcoidosis was defined as focal bone hypermetabolism with no argument for a differential diagnosis of bone 18F-FDG uptake. Patients with and without bone involvement were compared.
Among the 175 included patients, 32 (18%) had metabolic bone involvement of sarcoidosis. The metabolic bone involvement was mainly axial and mostly without bone abnormalities on CT. Metabolic bone involvement was associated with intrathoracic and extrathoracic lymph node involvement and with a greater number of organs involved. Patients with metabolic bone involvement more frequently received corticosteroids, methotrexate and TNF-α inhibitors and a greater number of treatments. Relapse of sarcoidosis occurred sooner in patients with metabolic bone involvement.
These results suggest that metabolic bone involvement is associated with more diffuse and more severe sarcoidosis.
结节病是一种多系统肉芽肿病，主要在年轻人中被诊断出来。18F-氟脱氧葡萄糖（18F-FDG）PET/CT在结节病病例中有助于寻找可活检部位或评估疾病活动度。18F-FDG PET/CT可揭示结节病患者的骨骼代谢亢进，即使在没有骨关节症状的情况下也是如此。本研究的目的是描述结节病患者的代谢性骨受累情况并评估其预后影响。
这是一项观察性、比较性、回顾性、单中心研究。纳入标准为根据结节病和其他肉芽肿病世界协会（WASOG）标准确诊的结节病，且在随访期间至少进行过一次18F-FDG PET/CT扫描。结节病的代谢性骨受累定义为局灶性骨代谢亢进，且无鉴别骨18F-FDG摄取的依据。对有和没有骨受累的患者进行比较。
在175例纳入患者中，32例（18%）有结节病的代谢性骨受累。代谢性骨受累主要在中轴骨骼，且CT上大多无骨骼异常。代谢性骨受累与胸内和胸外淋巴结受累以及更多器官受累相关。有代谢性骨受累的患者更频繁地接受皮质类固醇、甲氨蝶呤和TNF-α抑制剂治疗，且治疗次数更多。有代谢性骨受累的患者结节病复发更早。
这些结果表明，代谢性骨受累与更弥漫、更严重的结节病相关。
