Carlesimo M, Giustini S, Rossi A, Bonaccorsi P, Calvieri S
Department of Dermatology, University of Rome La Sapienza, Italy.
J Am Acad Dermatol. 1995 May;32(5 Pt 2):866-9. doi: 10.1016/0190-9622(95)91549-4.
Many therapeutic agents have been proposed for treatment of steroid-resistant sarcoidosis. Because administration of low doses of thalidomide has been successful in treating other inflammatory diseases, it was used in a patient with systemic sarcoidosis who was unresponsive to corticosteroids and in a patient with pulmonary sarcoidosis, in whom Kaposi's sarcoma developed after a course of corticosteroid therapy. Thalidomide, 200 mg/day for 2 weeks followed by 100 mg/day for 11 weeks, was given. This treatment was effective in both patients. No adverse reactions were observed. Thalidomide, 100 mg on alternate days, is still being administered. No relapse has occurred. Thalidomide, particularly because of its inhibition of the macrophage function, may be a useful alternative therapy in steroid-resistant cases. In addition, the correlation between the angiotensin-converting enzyme level and the clinical improvement observed in our patients suggests a direct parallel between angiotensin-converting enzyme and the activity of the granulomatous process.
许多治疗药物已被用于治疗激素抵抗性结节病。由于低剂量沙利度胺已成功用于治疗其他炎症性疾病，因此它被用于一名对皮质类固醇无反应的全身性结节病患者以及一名在接受皮质类固醇治疗后发生卡波西肉瘤的肺结节病患者。给予沙利度胺，200毫克/天，持续2周，随后100毫克/天，持续11周。该治疗对两名患者均有效。未观察到不良反应。仍在隔天给予100毫克沙利度胺。未发生复发。沙利度胺，特别是因其对巨噬细胞功能的抑制作用，可能是激素抵抗病例中一种有用的替代疗法。此外，我们患者中观察到的血管紧张素转换酶水平与临床改善之间的相关性表明血管紧张素转换酶与肉芽肿形成过程的活性之间存在直接平行关系。
