Takenaka K, Yanase T, Takayanagi R, Haji M, Ikuyama S, Nawata H
Third Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka.
Intern Med. 1995 Jun;34(6):580-3. doi: 10.2169/internalmedicine.34.580.
We present a 32-year-old-woman with Cushing's disease and sarcoidosis. She had been diagnosed as having Cushing's disease in 1985. She had transsphenoidal surgery followed by pituitary radiation. Subsequently her plasma cortisol level gradually decreased to normal range. In 1991, she manifested bilateral hilar lymphadenopathy on chest X-ray, erythema nodosum, subcutaneous nodules and granulomatous uveitis. From the histological findings of the skin lesions, the patient was diagnosed as having sarcoidosis. Interestingly, an inverse relationship between the disease activity of sarcoidosis and the level of serum cortisol in Cushing's disease was observed in the clinical course of this patient. Co-existence of Cushing's disease and sarcoidosis is very rare. Since the therapeutic significance of steroids in sarcoidosis has been well established, this case provides insight to the relationship between sarcoidosis and steroids.
我们报告一名32岁患有库欣病和结节病的女性。她于1985年被诊断为库欣病。她接受了经蝶窦手术，随后进行了垂体放疗。此后，她的血浆皮质醇水平逐渐降至正常范围。1991年，她胸部X线显示双侧肺门淋巴结肿大，出现结节性红斑、皮下结节和肉芽肿性葡萄膜炎。根据皮肤病变的组织学检查结果，该患者被诊断为结节病。有趣的是，在该患者的临床病程中，观察到结节病的疾病活动与库欣病血清皮质醇水平呈负相关。库欣病和结节病同时存在非常罕见。由于类固醇在结节病中的治疗意义已得到充分证实，该病例为结节病与类固醇之间的关系提供了见解。
