Yamamoto Ukyo, Ikuma Daisuke, Oba Yuki, Mizuno Hiroki, Sekine Akinari, Yamanouchi Masayuki, Hasegawa Eiko, Suwabebe Suwa Tatsuya, Kono Kei, Ohashi Kenichi, Wada Takehiko, Sawa Naoki, Ubara Yoshifumi
Nephrology Centern, Toranomon Hospital, Tokyo, Japan.
Nephrology Center, Toranomon Hospital, Tokyo, Japan.
Mod Rheumatol Case Rep. 2025 Jul 25;9(2). doi: 10.1093/mrcr/rxaf036.
We report the case of a 39-year-old man who was admitted for evaluation of enlarged lymph nodes. A lymph node biopsy showed CD68- and 1α-hydroxylase-positive non-caseating epithelioid granuloma. Sarcoidosis was diagnosed because of mildly elevated angiotensin-converting enzyme levels and hypercalcemia. We noted tattoos (which were created 10 years earlier) on the left upper arm and forearm. It was hypothesised that some component in the tattoos had triggered a systemic foreign body reaction by macrophages, resulting in sarcoidosis. Treatment with steroids was ineffective, but additional treatment with methotrexate plus adalimumab was successful.
我们报告了一例39岁男性因淋巴结肿大入院评估的病例。淋巴结活检显示CD68和1α-羟化酶阳性的非干酪样上皮样肉芽肿。由于血管紧张素转换酶水平轻度升高和高钙血症，诊断为结节病。我们注意到左上臂和前臂有纹身（10年前纹的）。据推测，纹身中的某些成分引发了巨噬细胞的全身性异物反应，导致了结节病。使用类固醇治疗无效，但甲氨蝶呤联合阿达木单抗的额外治疗取得了成功。
