Clinical features of sarcoidosis patients presenting with head and neck manifestations

Background and Aims Sarcoidosis is a multi-system granulomatous disease that most commonly manifests pulmonary (about 90 % ). The extrapulmonary manifestation is rare but also occurs in the head and neck area. Here it is essential that a first diagnosis there may be the first symptom of a possible chronic-systemic disease. Our study aims to demonstrate the diverse clinical manifestations and treatment options of sarcoidosis in the head and neck area.

Material and Methods We performed a retrospective cohort study at two university medical centers in Germany (Göttingen/ Bonn) and included all patients with a histopathologically confirmed diagnosis of sarcoidosis.

Results We identified 62 patients with sarcoidosis. In total, 85.4 %  (n=53) of patients received the initial diagnosis of sarcoidosis during their ENT treatment. Sarcoidosis was detected in the lymph nodes in 42.3 %  (n=30) of the patients; 57.7 %  had extra-lymphatic manifestations (e. g. paranasal sinuses or skin). Fifteen patients (24.2 % ) showed pulmonary involvement during chest X-Ray or chest-CT. 30.6 %  (n=19) of the patients were treated with oral glucocorticoids alone, three patients with corticoids and methotrexate, one patient, initially received a combination of corticoids and azathioprine, one patient rejected the recommended treatment. The other patients were at monitored without drug therapy.

Conclusions Sarcoidosis in the head and neck area should be considered as a differential diagnosis of lymphadenopathy, chronic sinusitis , or skin disorders. Upon initial detection by extrapulmonary sarcoidosis, further cardiac and pulmonology evaluation must be performed to rule out multisystemic involvement and help guide referral strategies in these patients as they may be the first physicians treating these patients.

Poster-PDF A-1286.pdf

Publication History

Article published online:
13 May 2021