神经结节病
Neurosarcoidosis.
作者信息
Tavee Jinny O, Stern Barney J
出版信息
Continuum (Minneap Minn). 2014 Jun;20(3 Neurology of Systemic Disease):545-59. doi: 10.1212/01.CON.0000450965.30710.e9.
PURPOSE OF REVIEW
This article provides an update on the evaluation and treatment of neurosarcoidosis.
RECENT FINDINGS
The broad range of clinical manifestations of neurosarcoidosis has recently expanded to include painful small fiber neuropathy. Although definitive diagnosis remains a challenge, fluorodeoxyglucose positron emission tomographic (FDG-PET) scan and high-resolution CT allow for improved detection of systemic sarcoidosis. In addition, endobronchial ultrasound-guided transbronchial needle aspiration provides a less invasive means of tissue confirmation of systemic sarcoidosis than mediastinoscopy. Although not standardized, treatment strategies for neurosarcoidosis now commonly include tumor necrosis factor-α antagonists in combination with corticosteroids and other cytotoxic agents for patients with severe disease.
SUMMARY
Advances in the diagnosis and management of neurosarcoidosis may benefit the patient and clinician faced with this multifaceted disease.
综述目的
本文提供了神经结节病评估与治疗的最新进展。
最新发现
神经结节病广泛的临床表现最近已扩展至包括疼痛性小纤维神经病变。尽管明确诊断仍然具有挑战性，但氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）和高分辨率CT有助于更好地检测系统性结节病。此外，与纵隔镜检查相比，支气管内超声引导下经支气管针吸活检为系统性结节病的组织确诊提供了一种侵入性较小的方法。尽管治疗策略尚未标准化，但对于患有严重疾病的神经结节病患者，目前常用的治疗策略包括肿瘤坏死因子-α拮抗剂联合皮质类固醇和其他细胞毒性药物。
总结
神经结节病诊断和管理方面的进展可能会使面临这种多方面疾病的患者和临床医生受益。
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