Salmon J-H, Perotin J-M, Direz G, Brochot P, Laredo J-D, Eschard J-P
Service de rhumatologie, CHU de Reims, 45, rue Cognacq-Jay, 51100 Reims, France.
Rev Med Interne. 2013 Jan;34(1):42-6. doi: 10.1016/j.revmed.2012.09.001. Epub 2012 Oct 1.
The prevalence of vertebral sarcoidosis is highly variable (1 to 36% of reported case series). Because of limited clinical expression, its frequency is probably underestimated. Its proper management is not clearly defined.
A 42-year-old woman who had a past medical history of cutaneous and pulmonary sarcoidosis presented with low back pain that was refractory to usual medical treatment. A diagnosis of vertebral localisation of sarcoidosis was considered on the history of proven sarcoidosis, radiological features, and the absence of evidence of an alternative diagnosis. In the absence of other clinical or biological evidence of active sarcoidosis, a simple follow-up was planned. MRI control at 1 year showed the resolution of vertebral sarcoidosis lesions.
Spontaneous regression is a possible outcome of vertebral sarcoidosis. Initiation of a specific treatment should be discussed in the absence of other visceral involvement.
脊椎结节病的患病率差异很大(在已报道的病例系列中为1%至36%)。由于临床表现有限,其发病率可能被低估。其恰当的治疗方法尚无明确定义。
一名42岁女性,有皮肤和肺部结节病病史,出现腰痛,常规药物治疗无效。根据已证实的结节病病史、放射学特征以及无其他诊断依据,考虑诊断为结节病脊椎定位。在无其他活动性结节病的临床或生物学证据的情况下,计划进行单纯随访。1年后的MRI检查显示脊椎结节病病变消退。
自发消退是脊椎结节病的一种可能结局。在无其他内脏受累的情况下,应讨论是否开始特定治疗。