Bergner Raoul
Medizinische Klinik A - Nephrologie, Rheumatologie, Hämato-Onkologie, Klinikum der Stadt Ludwigshafen, Bremserstr. 79, 67063, Ludwigshafen, Deutschland.
Z Rheumatol. 2023 Jun;82(5):389-403. doi: 10.1007/s00393-023-01338-1. Epub 2023 Jun 1.
Sarcoidosis is the most common granulomatous disease in northern Europe. A distinction is made between acute forms of sarcoidosis and chronic sarcoidosis. Chronic sarcoidosis can affect practically all organs but the lungs are affected in 90-95% of patients. The clinical appearance varies between asymptomatic and oligosymptomatic courses, which are diagnosed more by chance, to courses with acute organ failure. An extensive organ work-up is necessary at the time of the initial diagnosis in order to record the extent of organ involvement and to make appropriate treatment decisions. Asymptomatic courses with purely pulmonary sarcoidosis do not require treatment and can be observed over the course of the disease, whereas courses with extensive organ involvement or organ dysfunction require treatment. The treatment consists primarily of the administration of glucocorticoids. If the effect of the glucocorticoids is insufficient or if there are side effects, various immunosuppressive agents, including biologics can be added.
结节病是北欧最常见的肉芽肿性疾病。结节病分为急性型和慢性型。慢性结节病几乎可累及所有器官,但90%至95%的患者肺部会受到影响。临床表现从无症状和症状轻微(多偶然诊断)到急性器官衰竭不等。初次诊断时需要进行全面的器官检查,以记录器官受累程度并做出适当的治疗决策。单纯肺部结节病的无症状病程无需治疗,可在疾病过程中进行观察,而广泛器官受累或器官功能障碍的病程则需要治疗。治疗主要包括给予糖皮质激素。如果糖皮质激素效果不佳或出现副作用,可加用各种免疫抑制剂,包括生物制剂。