Popova E N, Strizhakov L A, Sholomova V I, Ponomarev A B, Moiseev S V, Brovko M U, Bondarenko I B, Ponomareva L A, Fomin V V
I.M. Sechenov First Moscow State Medical University, Faculty of Medicine, Chair of Internal Medicine No.1, Moscow, Russia.
Lomonosov Moscow State University, Faculty of Base Medicine, Department of Internal medicine, Moscow, Russia.
Ter Arkh. 2018 Feb 14;90(1):54-59. doi: 10.26442/terarkh201890154-59.
The article presents a clinical observation of two patients with generalized sarcoidosis. The woman typical granulomatous changes in the lungs and lymph nodes combined with atrial fibrillation, kidney failure and hereditary thrombophilia, men with atherosclerotic coronary arteries, re-myocardial infarction, cholestasis, tubulointerstitial nephritis. The accession of systemic manifestations was accompanied by increase of level of angiotensin-converting enzyme in the blood serum, morphological examination of lung tissue in both cases there were high histological activity of vasculitis and granulomatous inflammation. Extrapulmonary symptoms regressed when conducting immunosuppressive therapy. Discusses modern aspects of diagnosis of sarcoidosis in clinical practice.
本文介绍了两名全身性结节病患者的临床观察情况。该女性患者肺部和淋巴结出现典型的肉芽肿性改变，同时伴有心房颤动、肾衰竭和遗传性血栓形成倾向；男性患者有动脉粥样硬化性冠状动脉、再发性心肌梗死、胆汁淤积、肾小管间质性肾炎。全身症状出现时血清血管紧张素转换酶水平升高，两例患者肺组织形态学检查均显示血管炎和肉芽肿性炎症具有较高的组织学活性。进行免疫抑制治疗后肺外症状消退。文中讨论了临床实践中结节病诊断的现代相关问题。
