Lebacq E, Desmet V, Verhaegen H
Postgrad Med J. 1970 Aug;46(538):526-9. doi: 10.1136/pgmj.46.538.526.
Among 152 sarcoidosis patients, 11% had hypercalcaemia, 62% had hypercalciuria and 13·8% had at least one renal stone. Impairment of renal function was mostly conspicuous in patients with hypercalcaemia. Twenty-five successful percutaneous renal biopsies were performed. Epithelioid granulomas were seen in ten cases, with inflammatory reaction more prominent than in other organs involved by sarcoidosis, due to simultaneous pyelonephritis. Thickening and hyalinization of capsular membrane and glomeruli as well as arterial walls were frequently encountered. Amyloid deposits could be seen in one case with chronic lung infection. Histopathological changes specific of sarcoidosis are related to an abnormal amount of serum gammaglobulins and calciuria exceeding 200 mg in 24 hr, which seem to be the best tests of involvement by the disease. Tubular reabsorption of calcium was low in two patients with hypercalciuria, which was corrected after corticosteroid treatment. High intestinal calcium absorption was lowered after hydrochlorothiazide had decreased urine calcium.
在152例结节病患者中，11%有高钙血症，62%有高钙尿症，13.8%至少有1颗肾结石。肾功能损害在高钙血症患者中最为明显。成功进行了25例经皮肾活检。10例可见上皮样肉芽肿，由于同时存在肾盂肾炎，炎症反应比结节病累及的其他器官更突出。包膜、肾小球以及动脉壁的增厚和玻璃样变很常见。1例合并慢性肺部感染的患者可见淀粉样沉积。结节病的组织病理学变化与血清γ球蛋白异常量以及24小时尿钙超过200mg有关，这似乎是该疾病累及情况的最佳检测指标。2例高钙尿症患者的肾小管钙重吸收较低，皮质类固醇治疗后得到纠正。氢氯噻嗪减少尿钙后，肠道高钙吸收降低。
