Vaurs C, Ammoury A, Cordel N, Lamant L, Chaufour X, Paul C
Service de dermatologie, hôpital Purpan, CHU de Toulouse, 31059 Toulouse, France.
Ann Dermatol Venereol. 2009 Dec;136(12):890-3. doi: 10.1016/j.annder.2009.03.021.
Vascular involvement in sarcoidosis is very rare and is characterized by preferential involvement of large vessels similar to that observed in Takayasu's disease. Distinguishing between these two diseases is often difficult and constitutes a diagnostic pitfall. The association between sarcoidosis and Takayasu's arteritis is not coincidental and a common physiopathological factor may exist; it suggests a possible aetiopathogenetic relationship between sarcoidosis and Takayasu's arteritis and casts doubt on whether this form of vasculitis is a disease in its own right or simply a syndrome caused by other diseases.
We report the case of a man with a 10-year history of cutaneous and pulmonary sarcoidosis who developed ischaemia of the right upper limb evocative of Takayasu's arteritis. The patient was successfully treated with oral steroids and methotrexate.
This case prompts discussion about the relationship between Takayasu's disease and sarcoidosis. Physicians should be aware of the possible occurrence of granulomatous arteritis during the course of sarcoidosis which requires a special work-up.
结节病累及血管非常罕见，其特征是大血管受累为主，类似于高安氏病所见。区分这两种疾病往往很困难，构成诊断陷阱。结节病与高安氏动脉炎之间的关联并非偶然，可能存在共同的生理病理因素；这提示结节病与高安氏动脉炎之间可能存在病因学关系，并使人怀疑这种血管炎形式本身是否为一种疾病，还是仅仅是由其他疾病引起的综合征。
我们报告一名有10年皮肤和肺部结节病病史的男性病例，该患者出现提示高安氏动脉炎的右上肢缺血。患者接受口服类固醇和甲氨蝶呤治疗成功。
该病例引发了关于高安氏病与结节病之间关系的讨论。医生应意识到结节病病程中可能出现肉芽肿性动脉炎，这需要进行特殊检查。
