Limaye A P, Paauw D, Raghu G, Schmidt R A, Liles W C
Department of Medicine, University of Washington School of Medicine, Seattle, USA.
South Med J. 1997 Apr;90(4):431-3. doi: 10.1097/00007611-199704000-00015.
A 56-year-old previously healthy man had two episodes of unexplained pancreatitis in the setting of constitutional symptoms, recurrent palsy of the right seventh cranial nerve, and bilateral parotitis. Chest radiography revealed marked bilateral hilar lymphadenopathy, and sarcoidosis was diagnosed by bronchoscopy with transbronchial biopsy showing noncaseating granulomas. The pancreatitis and sarcoidosis responded to corticosteroid therapy but recurred after corticosteroid dosage was reduced. Retreatment with a higher dosage of corticosteroids led to resolution of pancreatitis; 3 months later, the patient remained well and without further recurrence of pancreatitis while taking the higher dose of corticosteroids. Clinically significant pancreatitis should be included as an unusual manifestation of sarcoidosis, and corticosteroid therapy should be considered in the management of pancreatitis associated with sarcoidosis.
一名56岁既往健康的男性，在出现全身症状、右侧第七颅神经反复麻痹和双侧腮腺炎的情况下，发生了两次不明原因的胰腺炎。胸部X线检查显示双侧肺门淋巴结明显肿大，通过支气管镜检查及经支气管活检发现非干酪样肉芽肿，从而诊断为结节病。胰腺炎和结节病对皮质类固醇治疗有反应，但在皮质类固醇剂量减少后复发。再次使用更高剂量的皮质类固醇治疗使胰腺炎得到缓解；3个月后，患者情况良好，在服用更高剂量皮质类固醇期间胰腺炎未进一步复发。临床上有意义的胰腺炎应被视为结节病的一种不寻常表现，在治疗与结节病相关的胰腺炎时应考虑使用皮质类固醇疗法。
