以肺外表现为首发症状的结节病临床分析

Extrapulmonary sarcoidosis of a clinical analysis

目的提高对首发于肺外表现的结节病的认识。方法回顾性分析了２２例肺外结节病的临床资料，所有病例均有病理检查资料。结果６例患者的首发肺外表现为周围淋巴结肿大，５例为皮肤改变，２例为眼部症状，３例为腮腺结节病，３例为骨关节炎，１例为心脏结节病，１例为肝脾肿大，１例为神经精神症状。部分肺外结节病的胸部Ｘ线检查正常，血管紧张素转化酶亦在正常范围内。结论某些以肺外表现为首发症状的结节病可能尚处于疾病的早期阶段，故早期诊断和治疗有助于缓解肺外症状。

Objective To improve the recognition of sarcoidosis with extrapulmonary manifestations as presenting symptoms. Methods The clinical manifestations and laboratory data of 22 cases of extrapulmonary sarcoidosis were analyzed. Results The clinical data were as follows: 6 patients presented with lymphadenopathy as the initial involvement, 5 cutaneous lesions, 2 ophthalmic involvement, 3 parotid sarcoidosis, 3 arthritic manifestations, 1 cardiac sarcoidosis, 1 hepatomegaly and splenomegaly and 1 neurologic complication. Chest X ray was normal and the levels of serum angiotension converting enzyme were not elevated in some of the patients. Most of patients were treated with systemic steroids and had the successful control of extrapulmonary manifestations. Conclusion Some cases of sarcoidosis which manifested with extrapulmonary involvement as initial signs or symptoms may be in the early stage of the disease. To establish the diagnosis of sarcoidosis early and treat the patients with suitable regimen are essential to improve the outcome of extrapulmonary sarcoidosis.