Wilson R, Lund V, Sweatman M, Mackay I S, Mitchell D N
Department of Thoracic Medicine, Brompton Hospital, London, UK.
Eur Respir J. 1988 Mar;1(3):269-72.
Of some 750 sarcoidosis patients, 27 were found to have involvement of their nasal mucosa. Most had multisystem disease, which was usually chronic. Nasal stuffiness or blockage and crusting were the major symptoms, and were usually present at the first presentation with sarcoidosis. The larynx was involved in five cases. The Kveim test was positive in twelve of the fourteen patients in whom it was performed, serum angiotensin converting enzyme was frequently elevated and sinus radiographs were often abnormal. Topical medication improved symptoms in some patients, but the majority required systemic corticosteroids. It was possible to withdraw medication completely after seven years in only one patient. Relapse was encountered during reduction of dosage in other patients. Random biopsy of macroscopically normal nasal mucosa did not yield histological support for a diagnosis of sarcoidosis in twelve out of thirteen patients, but upper respiratory tract lymphoid tissue may contain granulomas in patients with sarcoidosis.
在约750例结节病患者中，发现27例鼻黏膜受累。多数患者有多系统疾病，通常为慢性。鼻阻塞或堵塞以及结痂是主要症状，且在首次出现结节病时通常就已存在。5例患者喉部受累。14例接受Kveim试验的患者中有12例结果呈阳性，血清血管紧张素转换酶经常升高，鼻窦X线片常显示异常。局部用药使部分患者症状改善，但多数患者需要全身使用糖皮质激素。仅1例患者在7年后得以完全停药。其他患者在减药过程中出现复发。13例患者中有12例对肉眼外观正常的鼻黏膜进行随机活检，未获得结节病诊断的组织学依据，但结节病患者的上呼吸道淋巴组织可能含有肉芽肿。
