Mathur A, Kremer J M
Albany Medical College, New York.
Curr Opin Rheumatol. 1992 Feb;4(1):76-80.
A spectrum of immune alterations underlies the clinical syndrome of sarcoidosis. There is an increase in the number of helper T lymphocytes at sites of disease activity. Both macrophages and T cells are in a state of activation. Inflammation in sarcoidosis probably attracts specific T lymphocytes, as has been shown by the preferential usage of the C beta 1 elements of the T-cell antigen receptor. Acute sarcoid arthritis is distinctly different in its HLA association and clinical outcome than chronic sarcoid arthritis. Muscle and osseous lesions are well described but are usually asymptomatic. Childhood sarcoidosis may be confused with juvenile rheumatoid arthritis because of the similarity of eye and articular involvement. Nonsteroidal anti-inflammatory drugs and corticosteroids are effective for most patients. Hydroxychloroquine, methotrexate, and cyclosporine have been tried with success in patients with refractory sarcoidosis.
一系列免疫改变是结节病临床综合征的基础。在疾病活动部位，辅助性T淋巴细胞数量增加。巨噬细胞和T细胞均处于激活状态。结节病中的炎症可能会吸引特定的T淋巴细胞，这已通过T细胞抗原受体Cβ1元件的优先使用得到证实。急性结节病关节炎在HLA关联和临床结局方面与慢性结节病关节炎明显不同。肌肉和骨病变已有详细描述，但通常无症状。儿童结节病可能会因眼部和关节受累的相似性而与青少年类风湿性关节炎相混淆。非甾体类抗炎药和皮质类固醇对大多数患者有效。羟氯喹、甲氨蝶呤和环孢素已在难治性结节病患者中试用并取得成功。
