Korean Guidelines for Diagnosis and Management of Interstitial Lung Diseases: Park 7. Sarcoidosis.

IF 2.5 Q2 RESPIRATORY SYSTEM
Eun Joo Lee, Yangjin Jegal, Dong Won Park, Jimyung Park, Jun-Pyo Myong, Ji-Hyun Lee, Bo Hyoung Kang
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引用次数: 0

Abstract

Sarcoidosis is a granulomatous inflammatory disease of unknown etiology that can affect the entire body, but respiratory tract involvement is most common. In radiological findings, bilateral hilar and mediastinal lymph node enlargement is the most common finding, and when lung parenchyma is involved, findings such as micronodules, ground-glass shadows, reticular shadows, and fibrosis are seen. Biopsies for histological diagnosis are mainly performed on lymph nodes or lungs, and mediastinal lymph node biopsies are done via endobronchochial ultrasound-guided fine needle aspiration. Pathological findings are characterized by non-caseating, non-necrotizing granulomas, and in Korea, differentiation from tuberculosis is especially important. The natural history of sarcoidosis is very variable, with approximately two-thirds of subjects showing spontaneous remission and only 10-30% of patients showing a chronic or progressive form. The most important factor in determining treatment is whether there is a risk of death, organ failure, or loss of quality of life. Glucocorticosteroids are the mainstay of treatment, and if the disease progresses despite treatment, or if glucocorticosteroids cannot be reduced or cannot be used, immunosuppressants such as methotrexate and azathioprine can be considered. Response to glucocorticosteroids treatment is good, and most of the patients stabilize or improve, with a low mortality rate around 3-5%.

韩国肺间质性疾病的诊断和管理指南:Park 7。结节病。
结节病是一种病因不明的肉芽肿性炎症性疾病,可累及全身,但最常见的是累及呼吸道。影像学表现以双侧肺门及纵隔淋巴结肿大最为常见,累及肺实质时可见微结节、毛玻璃影、网状影及纤维化。组织学诊断的活检主要在淋巴结或肺部进行,纵隔淋巴结活检通过支气管超声引导下细针穿刺进行。病理表现为非干酪化、非坏死性肉芽肿,在韩国,与结核病的鉴别尤为重要。结节病的自然史非常多变,大约三分之二的受试者表现为自发缓解,只有10-30%的患者表现为慢性或进行性形式。决定治疗的最重要因素是是否存在死亡、器官衰竭或生活质量下降的风险。糖皮质激素是主要的治疗方法,如果治疗后病情继续恶化,或者糖皮质激素不能减少或不能使用,可考虑使用免疫抑制剂,如甲氨蝶呤和硫唑嘌呤。糖皮质激素治疗反应良好,大多数患者病情稳定或好转,死亡率低,约为3-5%。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.30
自引率
0.00%
发文量
42
审稿时长
12 weeks
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