Department of Pulmonology.
Department of Rheumatology, Zuyderland Medical Centre, Heerlen, Limburg.
Curr Opin Pulm Med. 2023 Sep 1;29(5):485-492. doi: 10.1097/MCP.0000000000000997. Epub 2023 Jul 17.
In recent years new recommendations have been published about organ assessment in the diagnosis of sarcoidosis.
Screening for pulmonary, cardiac, ocular, neurologic and renal involvement and hypercalcemia is recommended in the work-up for sarcoidosis, additionally, screening for hypercalciuria at the time of the diagnosis might be beneficial.
One of the goals in the work-up of sarcoidosis is to assess the extent and severity of organ involvement. Timely and accurate assessment leads to determination of treatment indication. Screening for pulmonary involvement should include pulmonary imaging and pulmonary function tests. Screening for cardiac involvement should include a clear history including palpitations and collapse and a baseline electrocardiogram or 24-h Holter monitoring. At diagnosis, ophthalmological assessment is recommended. Furthermore, serum calcium level and serum creatinine level should be obtained. Although routine 24-h urinary calcium excretion is not included in the guidelines, performing this test routinely can be considered. On indication, neurologic, rheumatologic or dermatologic assessment can be performed.
近年来，有关结节病诊断中器官评估的新建议已经发布。
在结节病的检查中，建议筛查肺部、心脏、眼部、神经和肾脏受累以及高钙血症，此外，在诊断时筛查高钙尿症可能有益。
结节病检查的目的之一是评估器官受累的程度和严重程度。及时准确的评估有助于确定治疗指征。肺部受累的筛查应包括肺部影像学和肺功能检查。心脏受累的筛查应包括详细的病史，包括心悸和晕厥，以及基线心电图或 24 小时动态心电图监测。在诊断时，建议进行眼科评估。此外，应获得血清钙和血清肌酐水平。尽管指南中不包括常规 24 小时尿钙排泄，但可以考虑常规进行该检查。根据指征，可以进行神经、风湿或皮肤科评估。
