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伴有骨髓受累及相关肌肉骨骼症状的瘢痕结节病。

Scar sarcoidosis with bone marrow involvement and associated musculoskeletal symptoms.

作者信息

Hameed Omair Akhtar, Skibinska Malgorzata

机构信息

General Medicine Department, Basildon University Hospital, London, Essex, UK.

出版信息

BMJ Case Rep. 2011 Dec 20;2011:bcr0220113863. doi: 10.1136/bcr.02.2011.3863.

Abstract

Sarcoidosis affects the lungs most commonly and can present with cutaneous lesions. It can also involve the bone marrow in rare instances, often presenting with non-specific symptoms such as fever and malaise, with occasional haematological abnormalities. The authors present the case of a 41-year-old caucasian female who was diagnosed with scar sarcoidosis, but who also reported fatigue, night sweats and polyarthralgia. No haematological abnormalities or lung involvement were detected. A magnetic resonance scan of the spine, performed due to disc prolapses, demonstrated areas of bone oedema and stress response that were reported as a possible sarcoid infiltration of the bone marrow. An improvement occurred after 8 weeks, despite conservative treatment. Bone marrow involvement in sarcoidosis is rarely reported, and was an accidental finding here. Due to the non-specific presentation, cases such as this are potentially underdiagnosed and should be considered in patients with systemic symptoms, regardless of their haematological status.

摘要

结节病最常累及肺部,也可出现皮肤病变。在罕见情况下,它还可累及骨髓,常表现为发热和不适等非特异性症状,偶尔伴有血液学异常。作者报告了一例41岁的白种女性病例,该患者被诊断为瘢痕结节病,但她也自述有疲劳、盗汗和多关节痛症状。未检测到血液学异常或肺部受累情况。因椎间盘突出进行的脊柱磁共振扫描显示有骨水肿和应激反应区域,报告认为这可能是结节病对骨髓的浸润。尽管采取了保守治疗,但8周后病情有所改善。结节病累及骨髓的情况鲜有报道,此处属于偶然发现。由于临床表现不具特异性,此类病例可能未得到充分诊断,对于有全身症状的患者,无论其血液学状况如何,均应考虑到这种情况。

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