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骨髓结节病一例罕见病例

A Rare Case of Bone Marrow Sarcoidosis.

作者信息

Shah Kejal, Enabi Joud, Kondakindi Hema, Mukkera Srikanth

机构信息

Internal Medicine, Texas Tech University Health Sciences Center, Odessa, USA.

Rheumatology, Texas Tech University Health Sciences Center, Odessa, USA.

出版信息

Cureus. 2024 Jul 6;16(7):e63991. doi: 10.7759/cureus.63991. eCollection 2024 Jul.

Abstract

Sarcoidosis is a systemic disease characterized by non-caseating epithelioid granulomas and can affect multiple organ systems, most commonly the lungs. Bone marrow involvement in sarcoidosis is rare and not well-documented. This case report details a 50-year-old female presenting with chronic lower back pain and significant hypercalcemia. Imaging revealed non-obstructive renal stones, liver nodularity, splenomegaly, and lung nodules. Initial treatments included corticosteroids for suspected sarcoidosis. Diagnostic workup, including bronchoalveolar lavage and various malignancy markers, was negative. A bone marrow biopsy showed non-caseating granulomas, confirming bone marrow sarcoidosis. This case underscores the importance of considering bone marrow involvement in patients with extrapulmonary sarcoidosis symptoms and highlights the need for a high index of suspicion among healthcare providers. Corticosteroids remain the primary treatment, with ongoing research into alternative therapies.

摘要

结节病是一种以非干酪样上皮样肉芽肿为特征的全身性疾病,可累及多个器官系统,最常见的是肺部。结节病累及骨髓较为罕见且文献记载不多。本病例报告详细介绍了一名50岁女性,她因慢性下背部疼痛和显著高钙血症就诊。影像学检查发现非梗阻性肾结石、肝脏结节、脾肿大和肺部结节。初始治疗包括使用皮质类固醇治疗疑似结节病。诊断性检查,包括支气管肺泡灌洗和各种恶性肿瘤标志物检查,结果均为阴性。骨髓活检显示非干酪样肉芽肿,确诊为骨髓结节病。本病例强调了在有肺外结节病症状的患者中考虑骨髓受累的重要性,并突出了医疗保健人员保持高度怀疑指数的必要性。皮质类固醇仍然是主要治疗方法,同时正在对替代疗法进行研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8801/11300181/7d4838bb0fc2/cureus-0016-00000063991-i01.jpg

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