Chapelon-Abric C
Service de médecine interne hôpital de La Pitié, Paris.
Rev Prat. 1994 Oct 1;44(15):2046-50.
Severe extrapulmonary sarcoidosis mainly consists of cardiac and neuromuscular involvement, both of which compromise the functional prognosis and survival. Their rare occurrence is a major factor in delayed diagnosis and treatment when they are the presenting signs of the disease, and especially when not associated to the "classic" signs of sarcoidosis. The lack of clinical and paraclinical specificity hinders diagnosis, and in the absence of histological evidence, all clinical and paraclinical factors compatible with sarcoidosis must be taken into account. Since these localisations are often asymptomatic or poorly symptomatic, they should be routinely sought by careful clinical examination and electrocardiogram. The presence of such signs modifies the therapeutic approach and requires treatment with corticosteroids.
重症肺外结节病主要包括心脏和神经肌肉受累,这两者都会影响功能预后和生存率。它们的罕见发生是疾病呈现这些症状时诊断和治疗延迟的主要因素,尤其是当它们与结节病的“典型”症状无关时。临床和辅助检查缺乏特异性会阻碍诊断,在没有组织学证据的情况下,必须考虑所有与结节病相符的临床和辅助检查因素。由于这些部位通常无症状或症状轻微,应通过仔细的临床检查和心电图进行常规筛查。这些症状的出现会改变治疗方法,需要使用皮质类固醇进行治疗。