Tateno S, Kobayashi Y
Department of Medicine, Kitasato University School of Medicine.
Nihon Rinsho. 1994 Jun;52(6):1613-8.
Clinically distinct renal disease is said to be rare in sarcoidosis, but autopsy reveals an incidence of renal involvement is 23 or 26% in Japanese studies. There are three categories of renal disease in sarcoidosis: 1) renal changes by abnormal calcium metabolism, 2) interstitial nephritis or granulomatous nephritis and 3) glomerulonephritis. Some investigators add renal angiitis to the three categories. In some patients without clinical renal disorders, renal involvement is discovered by chance at the time of autopsy or renal biopsy. Renal disease may develop during the course of sarcoidosis, preceding the diagnosis of sarcoidosis, or may be found simultaneously with extrarenal involvements at the time of diagnosis. Renal involvement should always be considered for exact diagnosis and appropriate treatment.
临床上,结节病伴发明显肾脏疾病的情况较为罕见,但尸检显示,在日本的研究中,肾脏受累的发生率为23%或26%。结节病的肾脏疾病有三类:1)钙代谢异常引起的肾脏改变;2)间质性肾炎或肉芽肿性肾炎;3)肾小球肾炎。一些研究者将肾血管炎也纳入这三类之中。在一些无临床肾脏疾病的患者中,肾脏受累是在尸检或肾活检时偶然发现的。肾脏疾病可能在结节病病程中出现,在结节病诊断之前,或者在诊断时与肾外受累同时被发现。为了准确诊断和恰当治疗,应始终考虑肾脏受累情况。