Hamdi Wafa, Néji Olfa, Ghannouchi Mohamed Mehdi, Kaffel Dhia, Kchir Mohamed Montacer
Service de Rhumatologie institut Kassab d'orthopédie-Manouba Tunisia.
Tunis Med. 2010 Nov;88(11):773-82.
Sarcoidosis is a systemic granulomatous disease of unknown etiology. It has various clinical features. The most commonly affected organs are the lung, the lymph nodes, the eyes and the skin. Involvement of the musculoskeletal system is far less common and may be inaugural. Articular involvement is dominated by Lofgren syndrome and acute polyarthritis. Abarticular manifestations are often confounded with arthritis. Bone locations are dominated by sarcoidosis dactylitis and osteolysis. Muscular involvement is often unknown and can appear as 3 clinical features: spread form, myositique form or pseudotumoral form. Calcium balance disturbances are dominated by hypercalcemia which is often asymptomatique, but sometimes it reveal the sarcoidosis. Treatment of rheumatologic disorders often involves non steroidal antiinflammatory drugs, corticosteroids and methotrexate. Biological therapies such as the anti-TNFa and the anti-CD20 were showed to be effective in some case reports of severe and refractory disease.
结节病是一种病因不明的系统性肉芽肿性疾病。它有多种临床特征。最常受累的器官是肺、淋巴结、眼睛和皮肤。肌肉骨骼系统受累则较为少见，且可能为首发表现。关节受累以 Löfgren 综合征和急性多关节炎为主。关节外表现常与关节炎混淆。骨骼部位以结节病性指（趾）炎和骨质溶解为主。肌肉受累情况通常不明，可表现为三种临床形式：播散型、肌炎型或假瘤型。钙平衡紊乱以高钙血症为主，通常无症状，但有时可提示结节病。风湿性疾病的治疗通常涉及非甾体类抗炎药、皮质类固醇和甲氨蝶呤。在一些严重难治性疾病的病例报告中，生物疗法如抗 TNFα 和抗 CD20 显示有效。
