Belfer M H, Stevens R W
St. Elizabeth Health Center Family Practice Residency, Youngstown, Ohio, USA.
Am Fam Physician. 1998 Dec;58(9):2041-50, 2055-6.
Sarcoidosis is a multisystemic disorder of unknown etiology that most commonly affects adults between 20 and 40 years of age. Patients with sarcoidosis frequently present with bilateral hilar lymphadenopathy and pulmonary infiltration, and often with ocular and skin lesions. The diagnosis is established when clinical and radiographic findings are supported by histologic evidence of non-caseating epithelioid cell granulomas found on tissue biopsy. Diagnosis of sarcoidosis requires exclusion of other causes of granuloma formation. Sarcoidosis is also characterized by distinctive laboratory abnormalities, including hyperglobulinemia, an elevated serum angiotensin converting enzyme level, evidence of depressed cellular immunity manifested by cutaneous anergy and, occasionally, hypercalcemia and hypercalciuria. Glucocorticoids remain the mainstay of therapy when treatment is required, although other anti-inflammatory agents are being used increasingly often.
结节病是一种病因不明的多系统疾病，最常见于20至40岁的成年人。结节病患者常表现为双侧肺门淋巴结肿大和肺部浸润，还常伴有眼部和皮肤病变。当组织活检发现非干酪样上皮样细胞肉芽肿的组织学证据支持临床和影像学表现时，即可确诊。结节病的诊断需要排除其他肉芽肿形成的原因。结节病还具有独特的实验室异常表现，包括高球蛋白血症、血清血管紧张素转换酶水平升高、皮肤无反应性所显示的细胞免疫功能低下，偶尔还会出现高钙血症和高钙尿症。尽管其他抗炎药物的使用越来越频繁，但在需要治疗时，糖皮质激素仍然是主要的治疗药物。
