Darabi Kamran, Torres Gilberto, Chewaproug Daranee
Department of Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA.
Scand J Urol Nephrol. 2005;39(2):173-5. doi: 10.1080/00365590510007667.
A 30-year-old black woman presented with a 1-year history of repeated episodes of worsening weight loss and fatigue. Physical examination showed no skin lesions and a chest roentgenogram was normal. Workup showed no obvious cause of recurrent renal stones. Finally, the detection of lymphadenopathy led to the diagnosis of extrapulmonary sarcoidosis. Up to 4% of all cases of sarcoidosis may present with urolithiasis only. Renal stones may be more common in severe cases of sarcoidosis, which affect blacks most frequently. Although not generally recommended for diagnostic purposes in sarcoidosis, in this case determination of the angiotensin-converting enzyme level was helpful in making the correct diagnosis. It is important that physicians are aware of the possibility that sarcoidosis may present as urolithiasis, even in the presence of a negative chest roentgenogram.
一名30岁的黑人女性，有1年反复出现体重减轻和疲劳加重发作的病史。体格检查未发现皮肤病变，胸部X线片正常。检查未发现复发性肾结石的明显病因。最后，淋巴结病的发现导致了肺外结节病的诊断。所有结节病病例中高达4%可能仅表现为尿石症。肾结石在严重的结节病病例中可能更常见，结节病最常影响黑人。虽然一般不建议将其用于结节病的诊断目的，但在该病例中，血管紧张素转换酶水平的测定有助于做出正确诊断。医生必须意识到，即使胸部X线片阴性，结节病也可能表现为尿石症。
