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[胃结节病]

[Gastric sarcoidosis].

作者信息

Maev I V, Andreev D N, Kucheriavyĭ Iu A

出版信息

Klin Med (Mosk). 2014;92(11):18-22.

Abstract

Sarcoidosis is a multisystemic disease of unknown etiology characterized by formation of non-caseificating epithelioid cell granulomas in affected organs. The clinically manifest involvement of the gastrointestinal tract (GIT) in the pathological process is documented in less than 1% of the patients, with stomach being involved in 10% ofthe cases. Pancreatic sarcoidosis is a very rare occurrence. Gastric sarcoidosis (GS) is usually an isolated disease but may be just as well a component of a generalized process. Isolated GS is as a rule a latent condition, its clinical symptoms (epigastric pain, nausea, vomiting) develop in association with erosion and ulceration of gastric mucosa. An endoscopic study of upper GIT may reveal narrowing of the distal half of the stomach with pre-pyloric ulcers or erosion and atrophy; thickened gastric folds may show up diffuse manifestations in the form of a "cobblestone pavement". The leading role in GS diagnostics is played by a histological study of gastric biopsies demonstrating classical sarcoid non-caseificating epithelioid cell granulomas. Treatment of GS must include intake of glucocorticoids and proton pump inhibitors.

摘要

结节病是一种病因不明的多系统疾病,其特征是在受影响的器官中形成非干酪样上皮样细胞肉芽肿。临床上胃肠道(GIT)在病理过程中的受累情况在不到1%的患者中得到记录,其中胃部受累的病例占10%。胰腺结节病非常罕见。胃结节病(GS)通常是一种孤立性疾病,但也可能是全身性疾病的一部分。孤立性GS通常是一种潜伏性疾病,其临床症状(上腹部疼痛、恶心、呕吐)与胃黏膜糜烂和溃疡有关。对上消化道进行内镜检查可能会发现胃远端半部变窄,伴有幽门前溃疡或糜烂及萎缩;增厚的胃皱襞可能会出现“鹅卵石路面”形式的弥漫性表现。GS诊断的主要依据是对胃活检进行组织学研究,显示典型的结节病非干酪样上皮样细胞肉芽肿。GS的治疗必须包括使用糖皮质激素和质子泵抑制剂。

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