Vasculitis in sarcoidosis patients is uncommon and can affect any size blood artery. There was little information known about this organization.

A single-institution medical records review research examined all patients with a sarcoidosis and vasculitis diagnostic code between January 1, 1998, and December 31, 2019. Data on diagnosis, treatment, and results were extracted from medical records. Biopsy and/or artery imaging were used to diagnose vasculitis in patients. A comparison was made between patients who had large and/or medium vascular vasculitis (L/MVV) and those who only had small vessel vasculitis (SVV).

During the research period, seventeen cases were identified. L/MVV affected nine patients (56% female), and SVV affected 8 individuals (50% female). Sarcoidosis occurred before vasculitis in 4 (44%) of the L/MVV cases and 3 (38%) of the SVV cases. In L/MVV and SVV, the mean ± SD age at sarcoidosis diagnosis was 53.2 ±17.8 and 51.9 ±11.4 years, respectively, while the mean SD age at vasculitis diagnosis was 57.4 ±19.6 and 59.0±13.4 years. Sarcoidosis affected a similar number of organ systems (median [interquartile range], 3 [1-4] L/MVV vs 2.5 [1.75-3.25] SVV). The average length of follow-up in L/MVV was 11.5±12.8 years and 13.1±14.3 years in SVV. A complete response to vasculitis treatment was reported in 8 of 9 patients with L/MVV and 7 of 8 patients with SVV. At the last follow-up, four patients with SVV were able to discontinue all immunosuppression, compared to only one patient with L/MVV. 

The study included a similar number of patients with L/MVV and SVV. Despite a range of therapies, most patients obtained remission, regardless of vessel size impacted. However, clinicians should be aware of the similarities and differences between sarcoidosis and vasculitis.