Red eyes presenting with a fistulous lesion in the left lower extremity: a case report

J Med Case Rep. 2015 Sep 11:9:206. doi: 10.1186/s13256-015-0661-1.

Abstract

Introduction: Very few cases of scar sarcoidosis affecting the eyes and bone together have been reported in the last few years.

Case presentation: We report a case of a 49-year-old Spanish man with recurrent bilateral granulomatous uveitis and a fistulous nodular lesion in the left pre-tibial region (scar granuloma) on the site of an 8-year-old scar. He presented with bilateral hilar adenopathies and elevation of inflammatory markers and angiotensin-converting enzyme. A histologically confirmed sarcoid of the tibia with a radiologic appearance unusual for long tubular bone involvement was observed. He also had bilateral ophthalmologic involvement.

Conclusions: Sarcoidosis is a disease of unknown cause histologically characterized by non-caseating granulomas that can involve any organ or tissue. Osseous sarcoidosis is a relatively rare presentation. However, on the basis of cases reported in the literature, sarcoid lesions on bones are generally asymptomatic. Biologic agents are considered an alternative therapy for sarcoidosis resistant to conventional treatment.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Cicatrix / complications
  • Cicatrix / diagnostic imaging
  • Cicatrix / drug therapy
  • Diagnosis, Differential
  • Granuloma / complications*
  • Granuloma / diagnostic imaging
  • Granuloma / drug therapy
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Lower Extremity / diagnostic imaging*
  • Male
  • Methotrexate / therapeutic use
  • Middle Aged
  • Prednisone / therapeutic use
  • Radiography
  • Sarcoidosis / complications*
  • Sarcoidosis / diagnostic imaging
  • Sarcoidosis / drug therapy
  • Tibia / diagnostic imaging
  • Uveitis / complications*
  • Uveitis / diagnostic imaging
  • Uveitis / drug therapy

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents
  • Immunosuppressive Agents
  • Prednisone
  • Methotrexate