小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 咳嗽
- 呼吸困难
- 慢性疲劳
- 关节痛
- 哮鸣音
- 干啰音
- 淋巴结肿大
- 畏光
- 痛性红眼
- 视力模糊
- 结节性红斑
- 冻疮样狼疮
- 结膜结节
- 面神经麻痹
其他诊断因素
- 没有铍暴露史
- 胸壁痛
- 咯血
- 体重减轻
- 低热
- 心律失常
- 心脏传导阻滞
- 肝肿大
- 头痛
- 惊厥
- 垂体损害的症状和征象
危险因素
- 20-50 岁
- 结节病家族史
- 斯堪的纳维亚人
- 女性
- 非吸烟者
- 黑人血统
- 黑人裔：葡萄膜炎
- 波多黎各血统：冻疮样狼疮
- 欧洲血统：结节性红斑
诊断性检查
首要检查
- 胸部 X 线检查
- 全血细胞计数 (FBC）
- 血清尿素
- 血清肌酐
- 肝酶
- 血清钙
- 肺功能检测 (PFT)
- 心电图 (ECG)
- 眼部检查
- γ 干扰素释放试验
需考虑的检查
- 血清 ACE 水平
- 胸部 CT 扫描
- 支气管内超声-经支气管针吸活组织检查术
- 支气管肺泡灌洗 (bronchoalveolar lavage, BAL)
- 皮肤活检
- 24 小时尿钙
- 镓-67 扫描
- 维生素 D
- 核磁共振成像 (MRI)
- (18)F-氟脱氧葡萄糖 (FDG) PET 扫描
新兴检查
- 3′-脱氧-3′-[18F]-氟胸苷（FLT）PET 扫描
- 4'-[甲基-11C]-硫代胸苷 PET/CT 扫描
治疗流程
对口服不耐受的急性呼吸衰竭
对口服耐受的急性呼吸衰竭
肺部疾病
皮肤病
眼部疾病
心血管疾病
中枢神经系统或周围神经系统受累
肾脏疾病
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 no competing interests.
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.
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