Birnbaum Andrea D, Oh Fred S, Chakrabarti Anindita, Tessler Howard H, Goldstein Debra A
Department of Ophthalmology, College of Medicine, University of Chicago at Illinois, 1855 W Taylor St., Chicago, IL 60612, USA.
Arch Ophthalmol. 2011 Apr;129(4):409-13. doi: 10.1001/archophthalmol.2011.52.
To compare the clinical characteristics of uveitic sarcoidosis in African American and non-African American patients with biopsy-proven sarcoidosis and to determine which diagnostic test results were most often suggestive of sarcoidosis in patients who were ultimately diagnosed as having the disease.
Retrospective review of consecutive patients with biopsy-proven sarcoidosis evaluated by the uveitis service between 1989 and 2009.
A total of 63 patients with uveitic sarcoidosis were identified: 39 (62%) were African American (P <.001) and 43 (68%) were female. African American patients presented at an earlier age (P <.001) and were more likely to have granulomatous anterior segment inflammation (P <.001). The levels of serum markers angiotensin-converting enzyme and lysozyme were elevated in 40% and 42% of patients tested, respectively. The levels of at least 1 marker were elevated in 18 patients (58%). Imaging study results were reported as consistent with sarcoidosis in 25 patients (69%) who underwent chest radiography and in 19 patients (100%) who underwent computed tomography.
In this series, African American patients were more likely to be diagnosed as having uveitic sarcoidosis and to present with uveitis if they were younger than 50 years. White patients were more likely to present when they were older than 50 years. A clinical picture that included granulomatous anterior segment inflammation was more common in African American patients. The use of serum markers (angiotensin-converting enzyme and lysozyme) positively identified more patients with biopsy-proven sarcoidosis when used in combination with appropriate chest imaging.
比较经活检证实为结节病的非裔美国人和非非裔美国人葡萄膜炎性结节病患者的临床特征，并确定哪些诊断检查结果最常提示最终被诊断为此病的患者患有结节病。
回顾性分析1989年至2009年间葡萄膜炎科评估的经活检证实为结节病的连续患者。
共确定63例葡萄膜炎性结节病患者：39例（62%）为非裔美国人（P<.001），43例（68%）为女性。非裔美国患者发病年龄较早（P<.001），更易出现肉芽肿性前段炎症（P<.001）。分别有40%和42%接受检测的患者血清标志物血管紧张素转换酶和溶菌酶水平升高。18例患者（58%）至少有1种标志物水平升高。胸部X线检查的25例患者（69%）和计算机断层扫描的19例患者（100%）的影像学检查结果报告与结节病相符。
在本系列研究中，非裔美国患者如果年龄小于50岁，更有可能被诊断为葡萄膜炎性结节病并出现葡萄膜炎。白人患者在年龄大于50岁时更易出现。包括肉芽肿性前段炎症的临床表现在非裔美国患者中更为常见。血清标志物（血管紧张素转换酶和溶菌酶）与适当的胸部影像学检查联合使用时，能更准确地识别更多经活检证实为结节病的患者。
