Section of Rheumatology, Department of Medicine, University of Chicago Medical Center, Chicago, IL 60637, USA.
Semin Respir Crit Care Med. 2010 Aug;31(4):463-73. doi: 10.1055/s-0030-1262214. Epub 2010 Jul 27.
Sarcoidosis is a systemic, clinically heterogeneous disease characterized by the development of granulomas. Any organ system can be involved, and patients may present with any number of rheumatologic symptoms. There are no U.S. Food and Drug Administration-approved therapies for the treatment of sarcoidosis. Diagnosing sarcoidosis becomes challenging, particularly when its complications cause patients' symptoms to mimic other conditions, including polymyositis, Sjögren syndrome, or vasculitis. This review presents an overview of the etiology of and biomarkers associated with sarcoidosis. We then provide a detailed description of the rheumatologic manifestations of sarcoidosis and present a treatment algorithm based on current clinical evidence for patients with sarcoid arthritis. The discussion will focus on characteristic findings in patients with sarcoid arthritis, osseous involvement in sarcoidosis, and sarcoid myopathy. Arthritic conditions that sometimes coexist with sarcoidosis are described as well. We present two cases of sarcoidosis with rheumatologic manifestations. Our intent is to encourage a multidisciplinary, translational approach to meet the challenges and difficulties in understanding and treating sarcoidosis.
结节病是一种系统性、临床表现多样的疾病，其特征为肉芽肿的形成。任何器官系统均可受累，患者可能表现出多种风湿学症状。目前，美国食品和药物管理局尚未批准用于结节病治疗的药物。诊断结节病具有一定挑战性，尤其是当并发症导致患者的症状类似于其他疾病时，如多发性肌炎、干燥综合征或血管炎。本文综述了结节病的病因和相关生物标志物。然后，我们详细描述了结节病的风湿学表现，并根据目前的临床证据为结节病性关节炎患者制定了治疗方案。讨论将重点关注结节病性关节炎患者的特征性表现、结节病中的骨受累以及结节病性肌病。同时，我们还将描述与结节病同时存在的关节炎情况。我们提供了两例具有风湿学表现的结节病病例。我们的目的是鼓励采取多学科、转化的方法来应对理解和治疗结节病的挑战和困难。
