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Sarcoidosis in World Trade Center Rescue Workers Presenting With Rheumatologic Manifestations

Bowers, Brian DO*; Hasni, Sarfaraz MD†; Gruber, Barry L. MD*

JCR: Journal of Clinical Rheumatology: January 2010 - Volume 16 - Issue 1 - pp 26-27
doi: 10.1097/RHU.0b013e3181c78856
Case Report

The health consequences of the World Trade Center collapse are unknown, but likely to be significant and may take years to fully appreciate. Sarcoidosis is a multisystem inflammatory disorder of unknown etiology characterized pathologically by noncaseating granulomas. Inciting events, such as infectious agents or possible environmental exposures, have been postulated as the source of antigen exposure initiating an inflammatory cascade. We describe 2 cases of sarcoidosis in rescue workers with significant exposure from the World Trade Center collapse, who presented with extrapulmonary rheumatologic manifestations. Our first case involved a 33-year-old white New York City man detective found to have sarcoidosis following an evaluation of diffuse joint pain. The second case involved a 40-year-old African American man, New York City officer, who presented with uveitis, and was subsequently diagnosed with sarcoidosis. These 2 cases extend the spectrum of disorders resulting from the World Trade Center disaster and illustrate the need for clinicians to be aware of the diverse presentations of sarcoidosis in this patient population.

These two cases add to previous reports of sarcoidosis-like illness after rescue work at the World Trade Center.

From the *Department of Medicine, New York College of Osteopathic Medicine, Old Westbury, NY; and †National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, MD.

Correspondence: Brain Bowers, DO, New York College of Osteopathic Medicine, P.O. Box 8000, Northern Blvd, Old Westbury, NY 11568. E-mail: BBower01@NYIT.edu.

© 2010 Lippincott Williams & Wilkins, Inc.