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
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
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
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
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
新兴检查
- 3'-deoxy-3'-[18F]-fluorothymidine (FLT) PET scan
- 4'-[methyl-11C]-thiothymidine PET/CT scan
治疗流程
acute respiratory failure unable to tolerate oral intake
acute respiratory failure able to tolerate oral intake
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
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.
鉴别诊断
- Tuberculosis
- Histoplasmosis
- Non-small cell lung cancer
更多 鉴别诊断指南
- 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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