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Sarcoidosis

最后审阅: 21 Sep 2025
最后更新: 01 Apr 2025

小结

定义

病史和体格检查

关键诊断因素

  • cough
  • dyspnea
  • chronic fatigue
  • arthralgia
  • wheezing
  • rhonchi
  • lymphadenopathy
  • photophobia
  • red painful eye
  • blurred vision
  • erythema nodosum
  • lupus pernio
  • conjunctival nodules
  • facial palsy
完整详情

其他诊断因素

  • absent history of exposure to beryllium
  • chest wall pain
  • hemoptysis
  • weight loss
  • low-grade fever
  • arrhythmias
  • heart block
  • hepatomegaly
  • headache
  • seizures
  • symptoms and signs of pituitary lesion
完整详情

危险因素

  • age 20-50 years
  • family history of sarcoidosis
  • Scandinavian origin
  • female sex
  • nonsmokers
  • black ancestry
  • black ancestry: uveitis
  • Puerto Rican origin: lupus pernio
  • European origin: erythema nodosum
完整详情

诊断性检查

首要检查

  • chest x-ray
  • CBC
  • serum BUN
  • serum creatinine
  • liver enzymes
  • serum calcium
  • PFTs
  • ECG
  • eye exam
  • interferon gamma release assay
完整详情

需考虑的检查

  • serum ACE
  • CT scan of chest
  • endobronchial ultrasound-transbronchial needle aspiration
  • bronchoalveolar lavage (BAL)
  • skin biopsy
  • 24-hour urine calcium
  • gallium-67 scan
  • vitamin D
  • MRI
  • (18)F-fluorodeoxyglucose (FDG) PET scan
完整详情

新兴检查

  • 3'-deoxy-3'-[18F]-fluorothymidine (FLT) PET scan
  • 4'-[methyl-11C]-thiothymidine PET/CT scan

治疗流程

急症处理

acute respiratory failure unable to tolerate oral intake

acute respiratory failure able to tolerate oral intake

持续性治疗

pulmonary disease

cutaneous disease

ocular disease

cardiovascular disease

central nervous system or peripheral nervous system involvement

renal disease

撰稿人

作者

Muthiah P. Muthiah, MD, FCCP

Acting Chief of Pulmonary, Critical Care & Sleep Medicine

VA Medical Center, Memphis

Professor & Vice Chair of Medicine

University of Tennessee Health Science Center

Memphis

TN

利益声明

MPM declares that he has no competing interests.

Amr El Gamal, MD, FCCP

Pulmonary and Critical Care

Medical Service

VA Medical Center

Martinsburg

Assistant Professor of Medicine

West Virginia University

Morgantown

WV

利益声明

AEG declares that he has served as a reviewer for the American Physician Institute.

同行评议者

George Swingler, MD

Professor

School of Child and Adolescent Health

Red Cross Children's Hospital

University of Cape Town

Rondebosch

Cape Town

South Africa

利益声明

GS declares that he has no competing interests.

Kyle Hogarth, MD, FCCP

Assistant Professor of Medicine

Department of Medicine

Section of Pulmonary and Critical Care

University of Chicago

Chicago

IL

利益声明

KH declares that he has no competing interests.

Marc Judson, MD

Chief

Division of Pulmonary and Critical Care Medicine

AMC Pulmonary and Critical Care Medicine

Albany

NY

利益声明

MJ declares that he has no competing interests.

Nadera Sweiss, MD

Assistant Professor of Medicine

Section of Rheumatology

Department of Medicine

University of Chicago

Chicago

IL

利益声明

NS declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

American Thoracic Society. Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999. Am J Respir Crit Care Med. 1999 Aug;160(2):736-55.全文  摘要

Thillai M, Atkins CP, Crawshaw A, et al. BTS clinical statement on pulmonary sarcoidosis. Thorax. 2021 Jan;76(1):4-20.全文  摘要

Crouser ED, Maier LA, Wilson KC, et al. Diagnosis and detection of sarcoidosis. An official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med. 2020 Apr 15;201(8):e26-51.全文  摘要

Cheng RK, Kittleson MM, Beavers CJ, et al. Diagnosis and management of cardiac sarcoidosis: a scientific statement from the American Heart Association. Circulation. 2024 May 21;149(21):e1197-216.全文  摘要

Baughman RP, Valeyre D, Korsten P, et al. ERS clinical practice guidelines on treatment of sarcoidosis. Eur Respir J. 2021 Dec;58(6):2004079.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Sarcoidosis images
  • 鉴别诊断

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    • Non-small cell lung cancer
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  • 指南

    • Diagnosis and management of cardiac sarcoidosis: a scientific statement from the American Heart Association
    • ERS clinical practice guidelines on treatment of sarcoidosis
    更多 指南
  • 患者教育信息

    Sarcoidosis

    更多 患者教育信息
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