Kobak Senol
Department of Internal Medicine and Rheumatology, Wasog Sarcoidosis Clinic, Faculty of Medicine, Liv Hospital, Istinye University, Istanbul, Turkey.
Lung India. 2020 Sep-Oct;37(5):425-432. doi: 10.4103/lungindia.lungindia_380_19.
Sarcoidosis is a systemic, chronic, inflammatory disease characterized by noncaseating granuloma formations. The fact that the etiopathogenesis of the disease has not been elucidated yet brings it many theories and assumptions. Being a systemic disease and ability to involve many organs and systems, it attracts the attention of physicians from different branches. In addition to lung involvement, skin, eye, heart, and locomotor system involvement is an important clinical finding. Sarcoidosis may present with very different clinical presentations, and therefore, it is one of the important "imitators" in the medical literature. I like sarcoidosis as a "rainbow," it is a disease that contains the characteristics of many diseases. Different clinical, radiological, and laboratory prognostic factors (lupus pernio, chronic uveitis, late-onset disease, chronic hypercalcemia, nephrocalcinosis, Afro-American race, progressive pulmonary sarcoidosis, radiologic Stage 4, bone involvement, neurosarcoidosis, cardiac involvement, and chronic respiratory failure) have been defined in this "rainbow." Early identification of these factors plays an important role in the determination of treatment strategies, morbidity, and mortality of the disease. In this article, clinical, genetic, laboratory, and radiological factors that determine the prognosis of sarcoidosis are discussed in light of the latest data in the literature.
结节病是一种以非干酪样肉芽肿形成为特征的全身性慢性炎症性疾病。该疾病的病因发病机制尚未阐明,这引发了许多理论和假设。作为一种全身性疾病且能够累及多个器官和系统,它吸引了不同科室医生的关注。除了肺部受累外,皮肤、眼睛、心脏和运动系统受累也是重要的临床发现。结节病可能呈现出非常不同的临床表现,因此,它是医学文献中重要的“模仿者”之一。我把结节病比作“彩虹”,它是一种包含多种疾病特征的疾病。在这个“彩虹”中已经定义了不同的临床、放射学和实验室预后因素(冻疮样狼疮、慢性葡萄膜炎、迟发性疾病、慢性高钙血症、肾钙质沉着症、非裔美国人种族、进行性肺部结节病、放射学4期、骨骼受累、神经结节病、心脏受累和慢性呼吸衰竭)。早期识别这些因素在确定疾病的治疗策略、发病率和死亡率方面起着重要作用。在本文中,将根据文献中的最新数据讨论决定结节病预后的临床、遗传、实验室和放射学因素。