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Osseous Sarcoidosis Treated With Tumor Necrosis Factor-Inhibitors

2010; Lippincott Williams & Wilkins; Volume: 35; Issue: 18 Linguagem: Inglês

10.1097/brs.0b013e3181dc9a54

1528-1159

Sarfaraz Hasni, Daniel A. Kunz, Kathleen C. Finzel, Barry L. Gruber,

Osteomyelitis and Bone Disorders Research

In Brief Study Design. Report of 2 cases of sarcoidosis involving vertebrae successfully treated with tumor necrosis factor-α inhibitor (TNF-α antagonist). Objective. To disseminate knowledge concerning successful treatment of sarcoidosis involving the axial skeleton with the use of TNF-α blockers. Summary of Background Data. Osseous sarcoidosis most commonly involves small bones of hands and feet; vertebral involvement is rare, and currently there is no consensus on optimal treatment. Methods. Two cases are described detailing patients with extrapulmonary sarcoidosis involving vertebral bodies, retractable to conventional treatment, who were treated with TNF-α antagonists. Results. We observed a remarkable response following the administration of TNF-α blockers in vertebral sarcoidosis with marked resolution of lytic lesions. The patients remained asymptomatic with no recurrence of their disease. Conclusion. Vertebral sarcoidosis is a rare manifestation of osseous sarcoidosis. Symptomatic patients are treated with various immunosuppressive therapies. We propose utilizing TNF-α blocking agents in patients who fail to respond to first-line therapy. Case reports of 2 patients with osseous sarcoidosis involving vertebrae. Patients were treated successfully with tumor necrosis factor alpha blocking agents. Review of literature showed no consensus with growing evidence of effectiveness of these agents against extrapulmonary sarcoidosis.