Tachibana T
Osaka Prefectural Hospital, Department of Internal Medicine.
Nihon Rinsho. 1994 Jun;52(6):1508-15.
In addition to 8th national survey on sarcoidosis in 1991, several other Japanese surveys on clinical features of sarcoidosis was performed and summarized by Tachibana and others. Selected data from these surveys are described in this paper Elderly female patients and detection by symptoms were predominant in 8th national survey, in contrary to the previous data of predominance of younger patients and detection by mass examination. 80 familial occurrence of sarcoidosis was collected in Japan. Brother-sister set was predominant, including two identical twins. Whereas age at detection of cardiac and various other extrathoracic lesions listed in 3 tables was mainly older than 40 years old, it was younger in the CNS involvement especially diabetes insipidus. As various extrathoracic lesions appeared even in stage 1 and also newly appeared during clinical course, careful follow up of the disease is necessary. Major complications of sarcoidosis were malignancy, tuberculosis, mycosis, herpes zoster and other infections and collagen diseases. Pulmonary mycosis was major complication of stage 3 sarcoidosis. Sarcoid reaction was found both in regional lymph nodes and primary malignant tumors, including lung and gastric cancer and others. Worsening of sarcoidosis after labor was found in relatively high frequency in stage 2 and 3, but also in stage 1.
除了1991年的第8次全国结节病调查外,日本还进行了其他几次关于结节病临床特征的调查,立花等人对这些调查进行了总结。本文介绍了这些调查中的部分选定数据。第8次全国调查中,老年女性患者和症状检出占主导,这与之前年轻患者占主导和通过大规模检查检出的情况相反。日本收集了80例结节病家族发病情况。兄弟姐妹组合占主导,其中包括一对同卵双胞胎。虽然3个表格中列出的心脏及其他各种胸外病变的检出年龄主要在40岁以上,但中枢神经系统受累尤其是尿崩症的检出年龄则较年轻。由于各种胸外病变即使在1期也会出现,并且在临床过程中也会新出现,因此对该疾病进行仔细随访很有必要。结节病的主要并发症有恶性肿瘤、结核病、真菌病、带状疱疹及其他感染和胶原病。肺真菌病是3期结节病的主要并发症。在区域淋巴结和原发性恶性肿瘤(包括肺癌和胃癌等)中均发现了结节病反应。产后结节病恶化在2期和3期的发生频率相对较高,但在1期也有发现。