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Wednesday, June 19, 2013
I have been diagnosed with sarcoid limited to the bone marrow. It continues to spread. My symptoms are somewhat helped with Plaquenil. But are there any medications or treatments to stop the spread. Also, are there any clinical trials involving the bone marrow?
There are a number of potential causes of granulomas in the bone marrow, including:
- fungal infections
- drug reactions
- and lymphomas (malignancy of the immune system).
Assuming that these other causes have been excluded and that sarcoidosis is the best explanation for your disease, the progression of the disease may respond to therapies other than Plaquenil (hydroxychloroquine), including corticosteroids and/or methotrexate. However, these treatments can be risky if there is an active infection, and they carry other potential side-effects.
I would encourage you to ask your doctor about how certain the diagnosis of sarcoidosis is and to discuss the treatment options. It is prudent to treat sarcoidosis with the least toxic drugs, at the lowest effective dose. In this context, Plaquenil is relatively safe, but is usually less effective than corticosteroids, methotrexate, and the other treatment options.
Elliott D Crouser, MD
Associate Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University