Migraine is commonly found in patients with sarcoidosis, according to a recent study published in Cephalalgia.
The symptoms of sarcoidosis are wide-ranging and diverse in a way that may make it challenging for clinicians to determine whether a specific complaint is symptomatic of sarcoidosis or caused by a different condition. This cohort study analyzed data on 96 study participants with sarcoidosis (55% female) and 39 healthy controls (56% female) to identify migraine frequency and predictors for migraine in patients with sarcoidosis. Neurosarcoidosis was present in 19% of study participants with sarcoidosis.
The University of California, San Francisco Sarcoidosis Research Program cohort recruited study subjects between January 2010 and May 2015. Study clinicians confirmed sarcoidosis diagnosis through clinical history and biopsy to identify non-necrotizing granulomas. Subjects with chronic infections, comorbid cancer, other pulmonary diseases, and other autoimmune diseases were excluded.
To diagnose migraine, a validated 3-question instrument called ID migraine was used. In the sarcoidosis group, 28 of the 96 sarcoidosis subjects (29%) screened positive for migraine, and 6 of those (33%) had neurosarcoidosis. Study strengths include the accuracy of ID migraine, which has a 93% positive rate of migraine diagnosis. Limitations include an inability to confirm migraine diagnosis via direct interview and the small study sample size.
Female sex was predictive of migraine in participants with sarcoidosis, as it is in the general population. Although the current study found migraine to be more prevalent in participants with sarcoidosis, this is likely to be a type 2 error stemming from the small sample size.
The study results indicate that migraine is as common in patients with sarcoidosis as it is in healthy controls, and larger studies would be necessary to determine whether it is more prevalent.
“Migraine should be considered in the differential diagnosis of recurrent headaches in patients with sarcoidosis, and better recognition and treatment of migraine has the potential to improve quality of life in this population,” the study authors concluded.
Gelfand JM, Gelfand AA, Goadsby PJ, Benn BS, Koth LL. Migraine is common in patients with sarcoidosis [published online March 26, 2018]. Cephalalgia. doi: 10.1177/0333102418768037