Menkes C J, Carter H
Ann Med Interne (Paris). 1987;138(1):26-9.
Sarcoid phalangeal involvement is a rare complication of a chronic disease process. Some forms pose difficult therapeutic problems, as steroids, even at high doses, do not always arrest the destructive changes. We report 3 cases of sarcoid phalangeal disease treated by intravenous infusion of 1 g of Methylprednisolone given in 3 hours on 3 consecutive days at monthly intervals for 4, 5, 7 and 8 months, respectively. Clinical improvement was rapid, constant and of excellent quality. The concentrations of the angiotensin converting enzyme returned to normal but Gallium 67 scintigraphy did not seem to be a helpful follow-up investigation. The radiological lesions were observed to regress during treatment in 1 case. Tolerance was excellent in the absence of maintenance steroid therapy. Further studies are required to assess the long term outcome.
结节病累及指骨是一种慢性疾病过程的罕见并发症。某些形式会带来棘手的治疗问题，因为即使大剂量使用类固醇，也并非总能阻止破坏性变化。我们报告3例结节病累及指骨的病例，分别每月间隔一次，连续3天在3小时内静脉输注1g甲泼尼龙，持续4、5、7和8个月。临床改善迅速、持续且效果极佳。血管紧张素转换酶浓度恢复正常，但镓67闪烁扫描似乎并非有效的随访检查手段。1例患者在治疗期间影像学病变有所消退。在未进行维持性类固醇治疗的情况下耐受性良好。需要进一步研究来评估长期疗效。
