ABSTRACT
Central nervous system sarcoidosis lesion is rare among patients with extrapulmonary tuberculosis. The lesion was encountered in 3 of the examined 120 patients with this condition. These 3 patients with cerebral sarcoidosis are used as an example to describe the clinical manifestations, diagnosis, and treatment of the disease. Its diagnosis is difficult. When such symptoms as fever, headache, thirst, etc., much alert is required in order to recognize CNS lesion as soon as possible. Its treatment has its own features.
Subject(s)
Brain Diseases , Sarcoidosis , Adult , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/therapeutic use , Brain/diagnostic imaging , Brain Diseases/diagnosis , Brain Diseases/diagnostic imaging , Brain Diseases/drug therapy , Brain Diseases/therapy , Drug Therapy, Combination , Estrogens/administration & dosage , Estrogens/therapeutic use , Female , Follow-Up Studies , Glucocorticoids/administration & dosage , Glucocorticoids/therapeutic use , Humans , Male , Plasmapheresis , Prednisolone/administration & dosage , Prednisolone/therapeutic use , Prognosis , Sarcoidosis/diagnosis , Sarcoidosis/diagnostic imaging , Sarcoidosis/drug therapy , Sarcoidosis/therapy , Time Factors , Tomography, X-Ray Computed , Triamcinolone Acetonide/administration & dosage , Triamcinolone Acetonide/therapeutic useABSTRACT
Sarcoidosis with atypical clinical manifestations and a poor course accounts for 5.6% (78 individuals per 1400 patients). The paper describes the atypical manifestations of sarcoidosis (fever, hypereosinophilia, lymphocytosis, etc.) and its poor course, which are similar to those of lymphoproliferative diseases, fibrosing alveolitis-type sarcoidosis, infiltrative pneumonic forms). Each of the above manifestations has complex differentially diagnostic aspects.
Subject(s)
Sarcoidosis/pathology , Diagnosis, Differential , Humans , Prognosis , Sarcoidosis/diagnosisABSTRACT
The authors studied the pattern of X-ray changes detectable in the lungs of 41 patients with LCH. The results of classical X-ray study were supplemented by the data of computed tomography, ultrasonography, and 99mTc and 67Ga citrate radioisotopic studies. The diagnostic values of these techniques were compared. X-ray syndromes of changes in the lung in LCH were found to be interstitial, interstitial and granulomatous, tumorous (focal). The authors emphasize the multisystematic character of a lesion, the phasic nature and progression of the disease into fibrosis.
Subject(s)
Histiocytosis, Langerhans-Cell/diagnostic imaging , Tomography, X-Ray Computed , Adolescent , Adult , Citrates , Diagnosis, Differential , Gallium , Gallium Radioisotopes , Humans , Middle Aged , Radionuclide Imaging , Radiopharmaceuticals , Technetium Tc 99m Aggregated Albumin , UltrasonographySubject(s)
Mycobacterium tuberculosis/isolation & purification , Sarcoidosis, Pulmonary/diagnosis , Aged , Antibodies, Bacterial/analysis , Bronchoalveolar Lavage Fluid/cytology , Bronchoalveolar Lavage Fluid/microbiology , Diagnosis, Differential , Female , Follow-Up Studies , Glucocorticoids/therapeutic use , Humans , Lymph Nodes/microbiology , Lymph Nodes/pathology , Mycobacterium tuberculosis/immunology , Prognosis , Sarcoidosis, Pulmonary/drug therapy , Sarcoidosis, Pulmonary/microbiology , Thorax , Tuberculin Test , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/microbiologyABSTRACT
Treatments were comparatively analyzed in two groups comprising 106 patients with respiratory sarcoidosis. One group of patients (n = 52) was treated with conventional therapy (corticosteroid hormones as tablets or aerosols, physiotherapy, SWF, plaquenil, antioxidants, the other (n = 54) received combined therapy (plasmapheresis, reduced hormone dosage, antioxidants. With both treatments, the early results of treatment were equally positive in 60-63% of patients, mainly in new cases of sarcoidosis. The late (3-year follow-up) ones were positive (no recrudescence) in 50 and 37% of patients treated with conventional and combined therapies, respectively. These outcomes are attributable to that combined therapy was used in more critical patients with disseminated and generalized processes and commonly at late stages of the disease.
