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麻风病还是结节病?诊断难题!

Leprosy or sarcoidosis? A diagnostic dilemma!

作者信息

Malkani Ram, Karia Rusina

机构信息

Department of Dermatology, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India.

出版信息

J Family Med Prim Care. 2018 Sep-Oct;7(5):1106-1108. doi: 10.4103/jfmpc.jfmpc_30_18.

DOI:10.4103/jfmpc.jfmpc_30_18
PMID:30598969
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6259513/
Abstract

There are two important differentials for non-caseating granulomatous inflammatory tissue-leprosy and sarcoidosis-which presents a diagnostic challenge due to their histological similarities and specific geographical distribution. This article describes a rare presentation of systemic sarcoidosis called Heerfordt's syndrome with the triad of parotitis, uveitis, fever, and optional paralysis of facial nerve. This case was initially diagnosed as leprosy.

摘要

对于非干酪样肉芽肿性炎症组织,有两个重要的鉴别诊断——麻风病和结节病——由于它们在组织学上的相似性和特定的地理分布,这带来了诊断挑战。本文描述了一种罕见的系统性结节病表现,称为黑尔福特综合征,其具有腮腺炎、葡萄膜炎、发热三联征以及面神经的选择性麻痹。该病例最初被诊断为麻风病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7956/6259513/3adbfcbfc1af/JFMPC-7-1106-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7956/6259513/3adbfcbfc1af/JFMPC-7-1106-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7956/6259513/3adbfcbfc1af/JFMPC-7-1106-g001.jpg

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1
Leprosy or sarcoidosis? A diagnostic dilemma!麻风病还是结节病?诊断难题!
J Family Med Prim Care. 2018 Sep-Oct;7(5):1106-1108. doi: 10.4103/jfmpc.jfmpc_30_18.
2
A Rare Case of Heerfordt's Syndrome with Bilateral Facial Palsy.双侧面瘫的黑尔福特综合征罕见病例。
Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 2):1027-1029. doi: 10.1007/s12070-016-0964-6. Epub 2016 Feb 19.
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Two Cases of Heerfordt's Syndrome: A Rare Manifestation of Sarcoidosis.两例黑福特综合征:结节病的罕见表现
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4
[67Ga scintigraphy in acute sarcoidosis with Heerfordt's syndrome].[镓-67闪烁扫描术在急性结节病合并黑尔福特综合征中的应用]
Nuklearmedizin. 1995 Feb;34(1):47-9.
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Heerfordt's Syndrome Associated with Trigeminal Nerve Palsy and Reversed Halo Sign.伴有三叉神经麻痹和反转性 halo 征的 Heerfordt 综合征。
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[Contribution to the knowledge of Heerfordt's syndrome (anatomo-clinical considerations on a case)].[对黑尔福特综合征认识的贡献(关于一例病例的解剖临床思考)]
Arch Ital Otol Rinol Laringol. 1960 Sep-Oct;71:669-84.
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[Radiculopathy in patients with Heerfordt's syndrome: two case presentations and review of the literature].[黑尔福特综合征患者的神经根病:两例病例报告及文献复习]
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Heerfordt's Syndrome Presenting with Recurrent Facial Nerve Palsy: Case report and 10-year literature review.以复发性面神经麻痹为表现的黑尔福特综合征:病例报告及10年文献综述
Sultan Qaboos Univ Med J. 2015 Feb;15(1):e124-8. Epub 2015 Jan 21.
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[Case of Heerfordt's syndrome presenting polyneuropathy].[以多发性神经病为表现的黑尔福特综合征病例]
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[Heerfordt's syndrome -- a rare initial manifestation of sarcoidosis].[黑尔福特综合征——结节病的一种罕见首发表现]
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引用本文的文献

1
Heerfordt's Syndrome Associated with Trigeminal Nerve Palsy and Reversed Halo Sign.伴有三叉神经麻痹和反转性 halo 征的 Heerfordt 综合征。
Intern Med. 2021 Jun 1;60(11):1747-1752. doi: 10.2169/internalmedicine.6176-20. Epub 2020 Dec 29.

本文引用的文献

1
Current clinical use of 18FDG-PET/CT in patients with thoracic and systemic sarcoidosis.18FDG-PET/CT 在胸肺和全身结节病患者中的当前临床应用。
Radiol Med. 2014 Jan;119(1):64-74. doi: 10.1007/s11547-013-0306-7. Epub 2013 Nov 15.
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A case of leprosy mistaken for cutaneous sarcoidosis.
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Hilar-lymphadenopathy predictive of cutaneous sarcoid.肺门淋巴结病提示皮肤结节病。
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[Heerfordt's syndrome -- a rare initial manifestation of sarcoidosis].[黑尔福特综合征——结节病的一种罕见首发表现]
Mund Kiefer Gesichtschir. 2005 Jan;9(1):43-7. doi: 10.1007/s10006-004-0582-4.
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Cutaneous sarcoidosis masquerading as relapsed borderline tuberculoid leprosy?伪装成复发性边缘型结核样麻风的皮肤结节病?
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Tuberculoid leprosy or sarcoidosis? A diagnostic dilemma.
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Clinical and biochemical aspects of sarcoidosis. With special reference to angiotensin-converting enzyme (ACE).结节病的临床与生化方面。特别提及血管紧张素转换酶(ACE)。
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Serum angiotensin converting enzyme in sarcoidosis: sensitivity and specificity in diagnosis: correlations with disease activity, duration, extra-thoracic involvement, radiographic type and therapy.结节病患者血清血管紧张素转换酶:诊断的敏感性和特异性:与疾病活动度、病程、胸外受累情况、影像学类型及治疗的相关性
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