[Splenomegaly in sarcoidosis: clinical features and outcome. Analysis of 17 cases]

Rev Med Interne. 2004 May;25(5):348-56. doi: 10.1016/j.revmed.2003.11.007.
[Article in French]

Abstract

Purpose: To describe the clinical features, biological datas and outcome of patients with systemic sarcoidosis and splenomegaly.

Methods: A retrospective analysis of 17 patients presenting splenomegaly and sarcoidosis with histological proof.

Results: Splenomegaly was clinically perceptible in 13 patients, with a spleen size that extended 4 cm or more below the costal margin in 11 patients. It was painful in five cases. The more frequent clinical features are constitutional symptom (fever in 9 cases) and hepatomegaly (N =7). Chest X-ray showed bilateral hilar lymphadenopathy in nine patients and no abnormality in five cases. Serum angiotensin converting enzyme levels were elevated in 81% of cases. Thrombopenia (N =5) and hypersplenism (N =5) were also observed. Corticosteroid were given to 88% with a good clinical and biological response including a decrease in the spleen volume. Corticotherapy and splenectomy (performed in two patients to rule out lymphoma) didn't change outcome of disease. Sarcoidosis is often chronical (82%) and extensive.

Conclusion: Splenomegaly may be present in sarcoidosis. Management is not standardized. Corticosteroid is indicated for symptomatic or massive splenomegaly. Splenomegaly is frequently in chronic and extensive sarcoidosis.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Adult
  • Diagnosis, Differential
  • Female
  • Fever / etiology
  • Humans
  • Male
  • Middle Aged
  • Pain / etiology
  • Retrospective Studies
  • Sarcoidosis / complications*
  • Splenectomy*
  • Splenomegaly / drug therapy*
  • Splenomegaly / etiology*
  • Splenomegaly / surgery
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones