Thornberry D K, Wheat L J, Brandt K D, Rosenthal J
Arthritis Rheum. 1982 Dec;25(12):1396-402. doi: 10.1002/art.1780251202.
During 2 recent epidemics of histoplasmosis in Indianapolis, 7 patients with hilar adenopathy and joint complaints were identified who were initially considered to have sarcoidosis, but in whom histoplasmosis was ultimately diagnosed on the basis of a positive culture for Histoplasma capsulatum or serologic studies. Articular features were the sole presenting complaints in 3 of these patients. All had arthralgias, which were generalized or confined to the lower extremities and were additive rather than migratory. Only 1 patient had joint swelling. Two had erythema nodosum. In all but 1 patient, the articular symptoms resolved rapidly and completely with minimal therapy. The data emphasize that sarcoidosis is a diagnosis of exclusion and that granulomatous infectious diseases must be excluded in patients with hilar adenopathy and joint disease.
在印第安纳波利斯最近发生的两起组织胞浆菌病疫情期间，发现了7例有肺门淋巴结肿大和关节症状的患者，他们最初被认为患有结节病，但最终根据荚膜组织胞浆菌培养阳性或血清学研究确诊为组织胞浆菌病。关节症状是其中3例患者唯一的首发症状。所有患者都有关节痛，疼痛范围广泛或局限于下肢，呈累加性而非游走性。只有1例患者有关节肿胀。2例有结节性红斑。除1例患者外，所有患者的关节症状经最少治疗后迅速且完全缓解。这些数据强调结节病是一种排除性诊断，对于有肺门淋巴结肿大和关节疾病的患者，必须排除肉芽肿性传染病。
