Panselinas Efstratios, Halstead Lucinda, Schlosser Rodney J, Judson Marc A
3rd Department of Pulmonary Medicine, Sismanoglion Hospital, Athens, Greece.
South Med J. 2010 Sep;103(9):870-5. doi: 10.1097/SMJ.0b013e3181ebcda5.
Sarcoidosis of the upper respiratory tract (SURT) is an underappreciated manifestation of sarcoidosis. We described the clinicoradiological findings, methods of treatment, and outcomes of 68 patients with SURT seen in our clinic over a 7-year period.
This was a retrospective study. A Case Control Etiology of Sarcoidosis Study (ACCESS) instrument of organ involvement was used to classify patients with SURT. Patients with a definite or probable diagnosis of SURT underwent chart review for symptoms, radiological features, treatment, and outcome.
There were 6.8% (68/998) of patients in the sarcoidosis clinic who had SURT. The most common presenting symptom was nasal congestion (61%, 34/56). In patients who had SURT diagnosed after the initial presentation of sarcoidosis, the mean prednisone dose more than quadrupled (4 + or - 6.5 vs 18.6 + or - 15.9, P = 0.002) between the diagnosis of SURT and the end of follow up. By the end of follow up, only 40% of our cohort had significant improvement of SURT.
SURT is a form of sarcoidosis that is not uncommon. Relatively high doses of corticosteroids are required to control the disease, and improvement occurs in a minority of the patients although the disease usually can be stabilized. Surgery should be reserved for life-threatening complications as surgical outcomes are relatively poor.
上呼吸道结节病（SURT）是结节病一种未得到充分认识的表现形式。我们描述了7年间在我们诊所就诊的68例SURT患者的临床放射学表现、治疗方法及预后情况。
这是一项回顾性研究。采用结节病病因病例对照研究（ACCESS）器官受累工具对SURT患者进行分类。确诊或疑似SURT的患者接受病历审查，以了解症状、放射学特征、治疗及预后情况。
结节病诊所中6.8%（68/998）的患者患有SURT。最常见的首发症状是鼻塞（61%，34/56）。在结节病初发后诊断为SURT的患者中，从SURT诊断到随访结束，泼尼松平均剂量增加了四倍多（4±6.5对比18.6±15.9，P = 0.002）。到随访结束时，我们队列中只有40%的患者SURT有显著改善。
SURT是结节病的一种形式，并不罕见。需要相对高剂量的皮质类固醇来控制疾病，虽然疾病通常可以稳定，但只有少数患者会有所改善。由于手术效果相对较差，手术应仅用于危及生命的并发症。
