{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:23:29Z","timestamp":1792808609059,"version":"4.5.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T00:00:00Z","timestamp":1638489600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Recurrent or persistently active sarcoidosis is a risk factor for permanent organ damage. Whether this damage is due to accumulated focal injuries or progressive disease extent is not known, as the natural history of chronic inflammation in sarcoidosis is poorly characterized. The objective of this study is to determine the pattern of disease in recurrently active sarcoidosis.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> We identified patients with recurrent cardiac sarcoidosis (<jats:italic>N<\/jats:italic> = 21) retrospectively from an imaging database, and with recurrent cutaneous sarcoidosis (<jats:italic>N<\/jats:italic> = 17) from a prospective registry. The longitudinal patterns of cardiac sarcoidosis were established by findings on cardiac positron emission tomography scans, and of cutaneous sarcoidosis by the validated Cutaneous Sarcoidosis Activity and Morphology Instrument clinical scoring system. Patterns of recurrent disease were compared to baseline findings.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Recurrent sarcoidosis occurred in a nearly identical pattern and distribution as baseline disease, and spread of disease was rarely observed for both cardiac and cutaneous sarcoidosis: 97% of heart segments positive on recurrence scans were positive on baseline scans, and only one new region of facial disease was observed. In some cases, recurrence followed years of apparent remission.<\/jats:p><jats:p><jats:bold>Discussion:<\/jats:bold> Across phenotypes, and across a long period of follow-up, the extent of sarcoidosis was stable in spite of fluctuations in disease activity. For patients with a demonstrated history of recurrent disease affecting critical organs, our findings support the need for long-term follow-up.<\/jats:p>","DOI":"10.3389\/fmed.2021.729229","type":"journal-article","created":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T05:15:11Z","timestamp":1638508511000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Stable Extent of Recurrently Active Cardiac and Cutaneous Sarcoidosis"],"prefix":"10.3389","volume":"8","author":[{"given":"Karen C.","family":"Patterson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misha","family":"Rosenbach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paco E.","family":"Bravo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob G.","family":"Dubroff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1164\/ajrccm.160.2.ats4-99","volume":"160","year":"1999","journal-title":"Am J Respir Crit Care Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1885","DOI":"10.1164\/ajrccm.164.10.2104046","article-title":"Clinical characteristics of patients in a case control study of sarcoidosis","volume":"164","author":"Baughman","year":"2001","journal-title":"Am J Respir Crit Care Med."},{"key":"B3","first-page":"423","article-title":"Reticuloendothelial system involvement in untreated sarcoidosis patients as assessed by 18F-FDG PET scanning","volume":"33","author":"Kalkanis","year":"2016","journal-title":"Sarcoidosis Vasc Diffuse Lung Dis."},{"key":"B4","doi-asserted-by":"publisher","first-page":"546","DOI":"10.5114\/aoms.2011.24118","article-title":"Cardiac sarcoidosis: a comprehensive review","volume":"7","author":"Sekhri","year":"2011","journal-title":"Arch Med Sci."},{"key":"B5","doi-asserted-by":"publisher","first-page":"2153","DOI":"10.1056\/NEJMra071714","article-title":"Sarcoidosis","volume":"357","author":"Iannuzzi","year":"2007","journal-title":"New Engl J Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1038\/s41572-019-0107-y","article-title":"Sarcoidosis","volume":"5","author":"Grunewald","year":"2019","journal-title":"Nat Rev Dis Primers."},{"key":"B7","doi-asserted-by":"publisher","first-page":"102462","DOI":"10.1016\/j.autrev.2020.102462","article-title":"Immune response biomarkers as indicators of sarcoidosis presence, prognosis, and possible treatment: an immunopathogenic perspective","volume":"19","author":"Tarasidis","year":"2020","journal-title":"Autoimmun Rev."},{"key":"B8","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1016\/j.ccm.2015.08.012","article-title":"Severe sarcoidosis","volume":"36","author":"Kouranos","year":"2015","journal-title":"Clin Chest Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1097\/MCP.0000000000000612","article-title":"Advanced sarcoidosis","volume":"25","author":"Baughman","year":"2019","journal-title":"Curr Opin Pulm Med."},{"key":"B10","first-page":"173","article-title":"The longitudinal study of chronic sarcoidosis","volume":"94","author":"Johns","year":"1983","journal-title":"Trans Am Clin Climatol Assoc."},{"key":"B11","doi-asserted-by":"publisher","first-page":"623","DOI":"10.1378\/chest.111.3.623","article-title":"Outcome in sarcoidosis. The relationship of relapse to corticosteroid therapy","volume":"111","author":"Gottlieb","year":"1997","journal-title":"Chest."},{"key":"B12","doi-asserted-by":"publisher","first-page":"481","DOI":"10.2214\/ajr.154.3.2106208","article-title":"Do chest radiographic findings reflect the clinical course of patients with sarcoidosis during corticosteroid withdrawal?","volume":"154","author":"Baumann","year":"1990","journal-title":"AJR."},{"key":"B13","doi-asserted-by":"publisher","first-page":"e003040","DOI":"10.1161\/JAHA.115.003040","article-title":"Magnetic resonance imaging as a predictor of survival free of life-threatening arrhythmias and transplantation in cardiac sarcoidosis","volume":"5","author":"Ekstr\u00f6m","year":"2016","journal-title":"J Am Heart Assoc."},{"key":"B14","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2013a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform."},{"key":"B15","doi-asserted-by":"publisher","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: Building an international community of software platform partners","volume":"95","author":"Harris","year":"2019","journal-title":"J Biomed Inform."},{"key":"B16","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1007\/s12350-016-0502-7","article-title":"Patient preparation for cardiac fluorine-18 fluorodeoxyglucose positron emission tomography imaging of inflammation","volume":"24","author":"Osborne","year":"2017","journal-title":"J Nucl Cardiol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1305","DOI":"10.1016\/j.hrthm.2014.03.043","article-title":"HRS expert consensus statement on the diagnosis and management of arrhythmias associated with cardiac sarcoidosis","volume":"11","author":"Birnie","year":"2014","journal-title":"Heart Rhythm."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1341","DOI":"10.2967\/jnumed.117.196287","article-title":"Joint SNMMI-ASNC expert consensus document on the role of (18)F-FDG PET\/CT in cardiac sarcoid detection and therapy monitoring","volume":"58","author":"Chareonthaitawee","year":"2017","journal-title":"J Nucl Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1001\/jamadermatol.2013.60","article-title":"Reliability and convergent validity of the cutaneous sarcoidosis activity and morphology instrument for assessing cutaneous sarcoidosis","volume":"149","author":"Rosenbach","year":"2013","journal-title":"JAMA Dermatol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1001\/jamadermatol.2019.3519","article-title":"Responsiveness to change and establishment of the minimal clinically important difference for the cutaneous sarcoidosis activity and morphology instrument","volume":"156","author":"Noe","year":"2020","journal-title":"JAMA Dermatol."},{"key":"B21","first-page":"204","article-title":"Two year prognosis of sarcoidosis: the ACCESS experience","volume":"20","author":"Judson","year":"2003","journal-title":"Sarcoidosis Vasc Diffuse Lung Dis."},{"key":"B22","doi-asserted-by":"publisher","first-page":"e0238391","DOI":"10.1371\/journal.pone.0238391","article-title":"Cardiac sarcoidosis: a long term follow up study","volume":"15","author":"Cacoub","year":"2020","journal-title":"PLoS ONE."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1598","DOI":"10.1164\/ajrccm\/147.6_Pt_1.1598","article-title":"Pulmonary sarcoidosis and corticosteroids","volume":"147","author":"Sharma","year":"1993","journal-title":"Am Rev Respir Dis."},{"key":"B24","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1136\/thx.22.6.519","article-title":"Prolonged treatment of pulmonary sarcoidosis with corticosteroids","volume":"22","author":"Hoyle","year":"1967","journal-title":"Thorax."},{"key":"B25","first-page":"212","article-title":"Recurrent sarcoidosis: a study of 17 patients with 24 episodes of recurrence","volume":"20","author":"Ma\u00f1\u00e1","year":"2003","journal-title":"Sarcoidosis Vasc Diffuse Lung Dis."},{"key":"B26","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1183\/09031936.00138913","article-title":"Relapses of sarcoidosis: what are they and can we predict who will get them?","volume":"43","author":"Baughman","year":"2014","journal-title":"Eur Respir J."},{"key":"B27","first-page":"201","article-title":"Effects of broad-spectrum antimycobacterial therapy on chronic pulmonary sarcoidosis","volume":"30","author":"Drake","year":"2013","journal-title":"Sarcoidosis Vasc Diffuse Lung Dis."},{"key":"B28","doi-asserted-by":"publisher","first-page":"350","DOI":"10.3389\/fped.2019.00350","article-title":"Immune Response to Mycobacterium tuberculosis: a narrative review","volume":"7","author":"de Martino","year":"2019","journal-title":"Front Pediatr."},{"key":"B29","doi-asserted-by":"publisher","first-page":"2480","DOI":"10.1172\/JCI19316","article-title":"Acquired predisposition to mycobacterial disease due to autoantibodies to IFN-gamma","volume":"115","author":"Kampmann","year":"2005","journal-title":"J Clin Invest."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1446","DOI":"10.1164\/rccm.201103-0409ED","article-title":"Who dies from sarcoidosis and why?","volume":"183","author":"Baughman","year":"2011","journal-title":"Am J Respir Crit Care Med."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2021.729229\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T05:15:17Z","timestamp":1638508517000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2021.729229\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,3]]},"references-count":30,"alternative-id":["10.3389\/fmed.2021.729229"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2021.729229","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,3]]},"article-number":"729229"}}