Sors C
Sem Hop. 1977 Jun 23;53(24):1399-1404.
Sarcoidosis is a disease defined by two criteria: one quantitative involvement if several organs or tissues showing its systemic character) the other qualitative (presence in all affected organs of giant cell and epitheloid cell granulomas without caseation). The first seems to counter balance the absence of specificity of the second. Unfortunately, the quantitative factor may be lacking in the mediastino-pulmonary forms owing to their apparently localised character. The diagnosis is thus based on a critical study of the clinical context (age, general health radiological appearances) and indirect signs of diffusion (biopsies, immune reactions, Kweim test). The therapeutic indications should take into consideration the tendancy to spontaneous recovery which occurs in 98% of cases. Prolonged corticosteroid therapy may be difficult to stop. No treatment should therefore be given unless there are complications or associated lesions exposing the patient to the risk of severe and permanent sequelae.
一个是定量标准(若多个器官或组织受累显示其系统性特征),另一个是定性标准(在所有受累器官中存在无干酪样坏死的巨细胞和上皮样细胞肉芽肿)。第一个标准似乎抵消了第二个标准缺乏特异性的问题。不幸的是,由于纵隔-肺型结节病明显的局限性特征,可能不存在定量因素。因此,诊断基于对临床背景(年龄、总体健康状况、放射学表现)的严格研究以及扩散的间接征象(活检、免疫反应、克维姆试验)。治疗指征应考虑到98%的病例会出现自发恢复的趋势。长期使用皮质类固醇治疗可能难以停药。因此,除非有并发症或相关病变使患者面临严重和永久性后遗症的风险,否则不应进行治疗。