Letterer Sebastian, Lindner Ulrich, Bernd Heinz-Wolfram, Vogt Florian M, Helmchen Udo, Lehnert Hendrik, Haas Christian S
Department of Medicine I and Nuclear Medicine , University of Luebeck , Luebeck , Germany.
Department of Pathology and Nuclear Medicine , University of Luebeck , Luebeck , Germany.
NDT Plus. 2011 Feb;4(1):28-31. doi: 10.1093/ndtplus/sfq184. Epub 2010 Oct 19.
Sarcoidosis can affect all organs and may mimic a variety of other diseases. In the absence of typical pulmonary features, extrapulmonary manifestations may be difficult to diagnose. We describe here the very uncommon case of a patient with mild pulmonal involvement but distinct renal, bone marrow and lymph node sarcoidosis. Treatment with glucocorticoids significantly improved kidney function and normalized serum calcium levels as well as the blood count. This case underscores the importance of sarcoidosis to be considered as a differential diagnosis of renal failure associated with hypercalcaemia and nephrocalcinosis. Bone marrow involvement should always be suspected if mono-, bi- or pancytopaenia coexist.
结节病可累及所有器官，并可能类似多种其他疾病。在缺乏典型肺部特征的情况下，肺外表现可能难以诊断。我们在此描述了一例非常罕见的病例，患者肺部受累较轻，但有明显的肾脏、骨髓和淋巴结结节病。糖皮质激素治疗显著改善了肾功能，使血清钙水平和血细胞计数恢复正常。该病例强调了结节病作为与高钙血症和肾钙质沉着症相关的肾衰竭鉴别诊断的重要性。如果存在单核细胞减少、双细胞减少或全血细胞减少，应始终怀疑有骨髓受累。
