Lindsley C B, Petty R E
Department of Pediatrics, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160 USA.
Curr Rheumatol Rep. 2000 Aug;2(4):343-8. doi: 10.1007/s11926-000-0073-z.
Interest in childhood sarcoidosis prompted the formation of an international registry in 1991. Over the next 5 years, 53 patients were registered by 23 physicians from 14 countries. All the patients had definite histologic evidence of sarcoidosis: noncaseating granulomas of the skin (31), synovium (15), liver (10), lymph node (eight), lung (five), muscle (four), conjunctiva (three), or kidney (one). All but nine patients developed polyarthritis; 38 of 44 had persistent arthritis. Of those with persistent polyarthritis, arthritis occurred at presentation in 16 of 38 patients and inflammation of the uveal tract of the eye occurred in 44 with involvement of both anterior and posterior segments in 21. One patient was blind at the time of the report. Other ocular complications included chorioretinitis, glaucoma, and phthisis bulbi. Laboratory abnormalities included mild anemia and elevated erythrocyte sedimentation rate (39 out of 45). Angiotensin converting enzyme levels were elevated in 14 out of 37 patients. Information on these patients with sarcoidosis helps develop a better understanding of this rare childhood disease. These patients are discussed in conjunction with an overview of sarcoid arthropathy.
对儿童结节病的关注促使在1991年成立了一个国际登记处。在接下来的5年里,来自14个国家的23名医生登记了53例患者。所有患者均有结节病的确切组织学证据:皮肤非干酪样肉芽肿(31例)、滑膜(15例)、肝脏(10例)、淋巴结(8例)、肺(5例)、肌肉(4例)、结膜(3例)或肾脏(1例)。除9名患者外,所有患者均出现多关节炎;44例中有38例患有持续性关节炎。在患有持续性多关节炎的患者中,38例中有16例在就诊时出现关节炎,44例出现葡萄膜炎,其中21例累及前段和后段。1例患者在报告时失明。其他眼部并发症包括脉络膜视网膜炎、青光眼和眼球痨。实验室异常包括轻度贫血和红细胞沉降率升高(45例中有39例)。37例患者中有14例血管紧张素转换酶水平升高。这些结节病患者的信息有助于更好地了解这种罕见的儿童疾病。这些患者将结合结节病性关节病的概述进行讨论。