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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Sarcoidosis is an inflammatory disease with unknown cause characterized by non-caseating granuloma formations&#46; It may present with bilateral hilar lymphadenopathy&#44; skin lesions&#44; the involvement of eye and symptoms on the locomotor system&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Gouty arthritis is an autoinflammatory disease which characterized by hyperuricemia&#44; recurrent arthritis attacks and the deposition of monosodium urate crystals in the joints and surrounding tissues&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a> Although the most common involvement is first MTP joints but it also may affect ankles&#44; knees and shoulder joints&#46; Usually it has been seen in the men and postmenopausal women and increases with increasing age&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Although etiopathogenesis of sarcoidosis and gouty arthritis are different&#44; some similar features are available &#40;self-limiting recurrent arthritis attacks&#44; good response to NSAIDs&#41;&#46; While the inflammasome complex has an important role in the pathogenesis of the gouty arthritis&#44; sarcoidosis are discussed will be also an autoinflammatory disease&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">4</span></a> Association of the gouty arthritis and sarcoidosis has been never reported in the literature and our case is the first in this regard&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Case Report</span><p id="par0020" class="elsevierStylePara elsevierViewall">45 years old male patient diagnosed and follow-up with sarcoidosis applied to our clinic because of pain and swelling of the both ankle joints and swelling&#44; redness and tenderness of the left first MTP joint&#46; During examination&#44; the patient described that previously had similar attacks in first MTP joints&#46; Patient&#39;s physical examination showed&#59; sensitivity of both ankle joints and swelling&#44; redness and reduced range of motion of left first MTP joint&#46; On laboratory tests&#59; the acute phase reactants&#44; serum uric acid and serum angiotensin converting enzyme &#40;ACE&#41; level were high &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; On radiological examinations&#59; there is no pathology on the radiograph of the ankle and toes except soft tissue swelling&#46; Chest radiography showed enlargement in both hilar area &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41; while thorax CT showed bilateral hilar lymphadenopathy &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Abdominal ultrasound was normal&#46; Serological tests was performed&#44; negative results for rheumatoid factor &#40;RF&#41;&#44; antinuclear antibody &#40;ANA&#41;&#44; anti-cyclic citrullinated peptide antibody &#40;anti-CCP Ab&#41;&#44; anti-neutrophil cytoplasmic antibody &#40;ANCA&#41;&#44; anti-dsDNA were determined&#46; Hepatitis markers &#40;HBV&#44; HCV&#44; HIV&#41; were normal&#46; Monosodium urate &#40;MSU&#41; crystals were showed in the fluid analysis of the joint puncture&#46; He has diagnosed with gouty arthritis and sarcoidosis according to clinical&#44; laboratory and radiologic evaluations&#46; Treatment with low-dose corticosteroids &#40;prednisolone 4<span class="elsevierStyleHsp" style=""></span>mg&#47;day&#41; and colchicine were initiated&#46; One month later the patient complaints and laboratory findings were regressed&#46; Six month later the radiological regression was observed on the control torax CT&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0025" class="elsevierStylePara elsevierViewall">We diagnosed our patient with gouty arthritis because of the episodic form of attacks&#44; the involvement of the first MTP joint which is a very typical for podagra and history of similar attacks previously&#46; Also we determined the MSU crystals in the synovial fluid analysis which support the exact diagnosis&#46; The joint involvement in the sarcoidosis may be seen in 10&#37;&#8211;25&#37; of cases&#46; It affects most often the ankle joint&#44; but knee&#44; wrist&#44; and metacarpophalangeal joints can also be involved&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a> Acute gouty arthritis occurs as monoarthritis in 70&#37; of patients and usually affects the first MTP joint&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">6</span></a> It can be confused with erysipelas and&#47;or with lymphangitis because of the redness in the joints&#46; Arthritis episodes regressed spontaneously in nearly one week or response well to colchicine treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">7</span></a> Sarcoid arthritis and gouty arthritis may coexist as in our case&#44; but sometimes acute sarcoid arthritis can also mimic gouty arthritis&#46; This coexistence may be purely coincidental and&#47;or related to a common etiopathogenesis&#46; Gouty arthritis is an autoinflammatory disease&#44; which is associated with inflammasome complex&#46; However&#44; there are hypothesis supporting that sarcoidosis may be autoinflammatory disease as well as gouty arthritis&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">8</span></a> Hyperuricemia is a important finding in both diseases and sometimes lead to confusion in the true diagnosis&#46; In sarcoidosis patients hyperuricemia is probably due to the defects of urate metabolism&#46; The presence of the phagocytosed monosodium urate crystals in the synovial fluid is important for the diagnosis of acute gouty arthritis&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">In conclusion&#44; we report herein a case with sarcoidosis coexist with gouty arthritis&#46; Both diseases may have similar clinical manifestations and exact diagnosis is important for prognosis and treatment&#46; Factors such as prevalence data&#44; absence of genetic relationship and response to treatment support the theory of coexistence rather than of common pathogenesis&#46; Multicentric studies that may shed light on this subject are needed&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Ethical Disclosures</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Protection of human and animal subjects</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Confidentiality of data</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Right to privacy and informed consent</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors have obtained the written informed consent of the patients or subjects mentioned in the article&#46; The corresponding author is in possession of this document&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conflict of Interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest&#46;</p></span></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La sarcoidosis es una enfermedad inflamatoria con causa desconocida caracterizada por formaciones de granulomas no caseificantes&#46; Puede presentarse con linfadenopat&#237;a hiliar bilateral&#44; lesiones cut&#225;neas&#44; afectaci&#243;n del ojo y s&#237;ntomas en el sistema locomotor&#46; La artritis gotosa es una enfermedad autoinflamatoria que se caracteriza por hiperuricemia&#44; ataques recurrentes de artritis y la dep&#243;sito de cristales de urato monos&#243;dico en las articulaciones y los tejidos circundantes&#46; Presentamos la coexistencia de sarcoidosis y artritis gotosa en este trabajo&#46;</p></span>"
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                  \t\t\t\t">Hemoglobin&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7300&#47;&#956;L&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3040&#8211;9640&#47;&#956;L&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Platelet count&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">269&#44;000&#47;&#956;L&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">150&#44;000&#8211;400&#44;000&#47;&#956;L&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">BUN&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Creatinine&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#46;67<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;5&#8211;0&#46;9<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Uric acid&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">ALT&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">AST&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">27<span class="elsevierStyleHsp" style=""></span>U&#47;L&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#8211;32<span class="elsevierStyleHsp" style=""></span>U&#47;L&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Calcium&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8&#46;6&#8211;10&#46;2<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Total protein&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">7&#46;8<span class="elsevierStyleHsp" style=""></span>g&#47;dl&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">6&#46;4&#8211;8&#46;3<span class="elsevierStyleHsp" style=""></span>g&#47;dl&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Albumin&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#46;5<span class="elsevierStyleHsp" style=""></span>g&#47;dl&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;4&#8211;4&#46;8<span class="elsevierStyleHsp" style=""></span>g&#47;dl&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">TSH&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;56<span class="elsevierStyleHsp" style=""></span>ng&#47;dl&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">23<span class="elsevierStyleHsp" style=""></span>mm&#47;h&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#8211;20<span class="elsevierStyleHsp" style=""></span>mm&#47;h&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">RF&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;9<span class="elsevierStyleHsp" style=""></span>IU&#47;ml&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#8211;14<span class="elsevierStyleHsp" style=""></span>IU&#47;ml&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ACE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">130<span class="elsevierStyleHsp" style=""></span>U&#47;L&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8&#8211;52<span class="elsevierStyleHsp" style=""></span>U&#47;L&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                      "titulo" => "Sarcoid arthritis&#58; clinical characteristics&#44; diagnostic aspects&#44; and risk factors"
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                          "autores" => array:6 [
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                        "tituloSerie" => "Ann Rheum Dis"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12006321"
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                      "doi" => "10.1016/S0140-6736(09)60883-7"
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                        "tituloSerie" => "Lancet"
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