Sarcoidosis - Recognition and treatment guidelines

被引:1
作者
Kaye, O
Ribbens, C
Kahn, MF
Malaise, MG
机构
[1] STATE UNIV LIEGE, DEPT RHEUMATOL, B-4000 LIEGE, BELGIUM
[2] UNIV PARIS 07, HOSP & FAC XAVIER BICHAT, DEPT RHEUMATOL, PARIS, FRANCE
关键词
D O I
10.2165/00063030-199707060-00003
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Sarcoidosis is a systemic disorder of unknown aetiology characterised by noncaseating granulomas leading principally to bilateral hilar lymphadenopathies, pulmonary infiltration and skin and eye lesions. Sarcoidosis may involve other organs, including peripheral lymph nodes, liver, spleen, nervous and musculoskeletal systems, heart, ear, nose and kidney. Although the clinical involvement of liver and heart is relatively uncommon, hepatic and cardiac granulomas are present at autopsy in about 70 to 80% and 25 to 50%, respectively, of patients with this disease. The diagnosis of sarcoidosis includes compatible clinical and/or radiological presentations and histological evidence of noninfectious and noncaseating epitheloid cell granulomas in the absence of other identifiable agents responsible for such histological lesions. Disease course is variable and usually characterised by frequent I emissions, bur it may become progressive and chronic in a small percentage of patients. The optimal treatment of sarcoidosis remains poorly defined. In patients with progressive pulmonary dysfunction as well as in those with severe extrapulmonary localisations, systemic corticosteroids usually; represent the first approach, limited by long term toxicity and frequent relapses after treatment interruption. In the presence of refractory or corticosertoid-dependent forms of the disease, antimalarial drugs or low dosage methotrexate may he used with prolonged benefit. The indications fur immunosuppressive agents such a; azathioprine, chlorambucil, cyclophosphamide and cyclosporin are uncommon and limited because of potentially serious adverse effects and lack of information on their long term efficacy. In the case of ocular and limited cutaneous manifestations, local corticosteroid therapy may be useful.
引用
收藏
页码:441 / 447
页数:7
相关论文
共 20 条
[1]   PRESENT STATUS OF TREATMENT OF PULMONARY SARCOIDOSIS - HOUSE DIVIDED [J].
DEREMEE, RA .
CHEST, 1977, 71 (03) :388-393
[2]   MYCOBACTERIUM-TUBERCULOSIS DNA IN TISSUE AFFECTED BY SARCOIDOSIS [J].
FIDLER, HM ;
ROOK, GA ;
JOHNSON, NM ;
MCFADDEN, J .
BRITISH MEDICAL JOURNAL, 1993, 306 (6877) :546-549
[3]   TRANSBRONCHIAL LUNG-BIOPSY IN SARCOIDOSIS - AN APPROACH TO DETERMINE THE OPTIMAL NUMBER OF BIOPSIES [J].
GILMAN, MJ ;
WANG, KP .
AMERICAN REVIEW OF RESPIRATORY DISEASE, 1980, 122 (05) :721-724
[4]   OUTCOME OF THE TREATMENT FOR SARCOIDOSIS [J].
HUNNINGHAKE, CW ;
GILBERT, S ;
PUERINGER, R ;
DAYTON, C ;
FLOERCHINGER, C ;
HELMERS, R ;
MERCHANT, R ;
WILSON, J ;
GALVIN, J ;
SCHWARTZ, D .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1994, 149 (04) :893-898
[5]   HYDROXYCHLOROQUINE IS EFFECTIVE THERAPY FOR CONTROL OF CUTANEOUS SARCOIDAL GRANULOMAS [J].
JONES, E ;
CALLEN, JP .
JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 1990, 23 (03) :487-489
[6]   CHLORAMBUCIL IN SARCOIDOSIS [J].
KATARIA, YP .
CHEST, 1980, 78 (01) :36-43
[7]  
KAYE O, 1995, BRIT J RHEUMATOL, V34, P642
[8]   SPONTANEOUS REMISSION OR RESPONSE TO METHOTREXATE IN SARCOIDOSIS [J].
LACHER, MJ .
ANNALS OF INTERNAL MEDICINE, 1968, 69 (06) :1247-+
[9]   SERIAL CHANGES IN MARKERS OF DISEASE-ACTIVITY WITH CORTICOSTEROID TREATMENT IN SARCOIDOSIS [J].
LAWRENCE, EC ;
TEAGUE, RB ;
GOTTLIEB, MS ;
JHINGRAN, SG ;
LIEBERMAN, J .
AMERICAN JOURNAL OF MEDICINE, 1983, 74 (05) :747-756
[10]   THE USE OF LOW-DOSE METHOTREXATE IN REFRACTORY SARCOIDOSIS [J].
LOWER, EE ;
BAUGHMAN, RP .
AMERICAN JOURNAL OF THE MEDICAL SCIENCES, 1990, 299 (03) :153-157