Geriatrics Clinic, Medicine Department, SS Annunziata Hospital of Chieti, Chieti, Italy.
Department of Pharmacology and Toxicology, Faculty of Health, Medicine and Life Science, Maastricht University, Maastricht, The Netherlands.
Ann Med. 2022 Dec;54(1):1014-1035. doi: 10.1080/07853890.2022.2063375.
Sarcoidosis is a heterogeneous disease, which can affect virtually every body organ, even though lungs and intra thoracic lymph nodes are almost universally affected. The presence of noncaseating granulomas is the histopathological hallmark of the disease, and clinical picture depends on the organs affected. Data about interaction between sarcoidosis and comorbidities, such as cardiovascular and pulmonary diseases, autoimmune disorders, malignancy and drug-related adverse events are limited. Several lung conditions can be associated with sarcoidosis, such as pulmonary hypertension and fibrosis, making it difficult sometimes the differentiation between complications and distinctive pathologies. Their coexistence may complicate the diagnosis of sarcoidosis and contribute to the highly variable and unpredictable natural history, particularly if several diseases are recognised. A thorough assessment of specific disorders that can be associated with sarcoidosis should always be carried out, and future studies will need to evaluate sarcoidosis not only as a single disorder, but also in the light of possible concomitant conditions.Key messagesComorbidities in sarcoidosis are common, especially cardiovascular and pulmonary diseases.In the diagnostic workup, a distinction must be made between sarcoidosis-related complaints and complaints caused by other separate disorders. It can be very difficult to distinguish between complications of sarcoidosis and other concomitant conditions.The coexistence of multiple conditions may complicate the diagnosis of sarcoidosis, affect its natural course and response to treatment.
结节病是一种异质性疾病,几乎可以影响到人体的每一个器官,尽管肺部和胸内淋巴结几乎普遍受到影响。无干酪样坏死性肉芽肿的存在是该病的组织病理学标志,临床表现取决于受影响的器官。关于结节病与合并症(如心血管和肺部疾病、自身免疫性疾病、恶性肿瘤和药物相关不良事件)之间相互作用的数据有限。几种肺部疾病可能与结节病有关,如肺动脉高压和纤维化,这使得有时难以区分并发症和独特的病理学。它们的共存可能会使结节病的诊断复杂化,并导致高度可变和不可预测的自然病程,特别是如果同时存在几种疾病。应该始终对可能与结节病相关的特定疾病进行彻底评估,未来的研究不仅需要评估结节病作为单一疾病,还需要根据可能的伴随疾病进行评估。
关键信息
结节病的合并症很常见,尤其是心血管和肺部疾病。
在诊断性检查中,必须区分与结节病相关的症状和由其他单独疾病引起的症状。区分结节病的并发症和其他伴随疾病非常困难。
多种疾病共存可能使结节病的诊断复杂化,影响其自然病程和对治疗的反应。