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Sarcoidosis with high serum levels of vascular endothelial growth factor (VEGF), showing RS3PE-like symptoms in extremities

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Abstract

We report a patient with sarcoidosis who showed edema in the distal portion of all extremities, particularly the legs, as seen in remitting seronegative symmetrical synovitis with pitting edema (RS3PE). Magnetic resonance imaging demonstrated diffuse abnormal intensity in subcutaneous tissues of both legs, and skin biopsy led to a diagnosis of sarcoidosis. Vascular endothelial growth factor (VEGF) showed a high serum level, which decreased soon after starting oral prednisolone, in parallel with an improvement in the limb edema. In this patient VEGF as well as infiltration by sarcoid granuloma in the skin might have played an important role in the pathogenesis of RS3PE-like symptoms in the extremities. When painful pitting edema is seen predominantly in the distal portion of all extremities, sarcoidosis as well as RS3PE should be considered as a possible diagnosis.

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Abbreviations

ACE:

Angiotensin converting enzyme

RS3PE:

Remitting seronegative symmetrical synovitis with pitting edema

VEGF:

Vascular endothelial growth factor

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Authors and Affiliations

  1. Third Department of Medicine, Shinshu University School of Medicine, 3–1-1 Asahi, 390–8621, Matsumoto, Japan

    Masayuki Matsuda, Kumi Sakurai, Tomohisa Fushimi, Kanji Yamamoto & Shu-ichi Ikeda

  2. Department of Dermatology, Maruko Central Hospital, Maruko, Japan

    Shiho Rokuhara

  3. Department of Medicine, Maruko Central Hospital, Maruko, Japan

    Naritoshi Hosaka

Authors
  1. Masayuki Matsuda
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  2. Kumi Sakurai
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  3. Tomohisa Fushimi
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  4. Kanji Yamamoto
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  5. Shiho Rokuhara
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  6. Naritoshi Hosaka
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  7. Shu-ichi Ikeda
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Correspondence to Masayuki Matsuda.

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Matsuda, M., Sakurai, K., Fushimi, T. et al. Sarcoidosis with high serum levels of vascular endothelial growth factor (VEGF), showing RS3PE-like symptoms in extremities. Clin Rheumatol 23, 246–248 (2004). https://doi.org/10.1007/s10067-003-0840-0

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  • DOI: https://doi.org/10.1007/s10067-003-0840-0

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