Weinberger Steven E
University of Pennsylvania School of Medicine, Philadelphia, USA.
JAMA. 2006 Nov 1;296(17):2133-40. doi: 10.1001/jama.296.17.2133.
Ms K, a 47-year-old woman, was found to have sarcoidosis after evaluation of an abnormal chest radiograph obtained during work-up of a recently diagnosed melanoma. She has symptoms of fatigue, achiness, and exertional dyspnea. She believes her symptoms are due to sarcoidosis and would like to get some symptomatic improvement, though she is reluctant to be treated with corticosteroids. She is interested in knowing about the likely course of her disease and the potential treatment options. The various presentations, protean manifestations, variable natural history, and attempts to understand the etiology of sarcoidosis are discussed. The principles underlying the decision of whether to institute treatment, the options for treatment, and the effectiveness of treatment are reviewed.
K女士，一名47岁女性，在对近期诊断的黑色素瘤进行检查时拍摄的胸部X光片异常，经评估后被发现患有结节病。她有疲劳、疼痛和劳力性呼吸困难的症状。她认为自己的症状是由结节病引起的，希望症状能有所改善，不过她不愿接受皮质类固醇治疗。她想了解自己疾病可能的病程以及潜在的治疗选择。本文讨论了结节病的各种表现、千变万化的症状、多变的自然病程以及对其病因的探索。同时回顾了决定是否进行治疗的基本原则、治疗选择以及治疗效果。
