AP-HP, Pulmonology Department, Avicenne Hospital, Bobigny, 93009, France; INSERM UMR 1272, Sorbonne Paris-Nord University, Bobigny, 93009, France.
INSERM UMR 1272, Sorbonne Paris-Nord University, Bobigny, 93009, France; AP-HP, Radiology Department, Avicenne Hospital, Bobigny, 93009, France.
Clin Chest Med. 2024 Mar;45(1):199-212. doi: 10.1016/j.ccm.2023.08.011. Epub 2023 Sep 4.
Fibrotic pulmonary sarcoidosis (fPS) affects about 20% of patients. fPS carries a significant morbidity and mortality. However, its prognosis is highly variable, depending mainly on fibrosis extent, functional impairment severity, and the development of pulmonary hypertension. Moreover, fPS outcomes are also influenced by several other complications, including acute exacerbations, and infections. fPS natural history is unknown, in particular regarding the risk of progressive self-sustaining fibrosis. The management of fPS is challenging, including anti-inflammatory treatment if granulomatous activity persists, rehabilitation, and in highly selected patients antifibrotic treatment and lung transplantation.
纤维化型肺结节病(fPS)影响约 20%的患者。fPS 具有显著的发病率和死亡率。然而,其预后高度可变,主要取决于纤维化程度、功能损害严重程度和肺动脉高压的发展。此外,fPS 的结果还受到其他几种并发症的影响,包括急性加重和感染。fPS 的自然病史尚不清楚,特别是关于持续进展性自维持纤维化的风险。fPS 的管理具有挑战性,包括如果肉芽肿活动持续存在时的抗炎治疗、康复,以及在高度选择的患者中进行抗纤维化治疗和肺移植。