Journal Information
Vol. 14. Issue 1.
Pages 127-140 (January - February 2008)
Share
Share
Download PDF
More article options
Vol. 14. Issue 1.
Pages 127-140 (January - February 2008)
Artigo de Revisão/Revision Article
Open Access
Sarcoidose extratorácica
Extra-thoracic sarcoidosis
Visits
5422
Filipa Costa1, Ana Arrobas2
1 Interna do Internato Complementar de Pneumologia, Serviço de Pneumologia, Centro Hospitalar de Coimbra
2 Assistente Hospitalar Graduada de Pneumologia, Serviço de Pneumologia, Centro Hospitalar de Coimbra
This item has received

Under a Creative Commons license
Article information
Resumo

A sarcoidose é uma doença granulomatosa multissistémica de etiologia desconhecida, caracterizada histologicamente pela presença de granulomas não caseosos nos órgãos envolvidos. Trata-se de uma doença que pode envolver praticamente qualquer órgão, manifestando-se de múltiplas formas e apresentando-se a várias especialidades clínicas. O envolvimento extratorácico isolado é raro (10%), surgindo mais frequentemente associado ao envolvimento pulmonar ou dos gânglios linfáticos mediastínicos.

A nível extratorácico pode ocorrer, entre outros, envolvimento do fígado (50-80%), baço (40-80%), olho (20-50%), nódulos linfáticos periféricos (30%), pele (25%), sistema nervoso (10%), coração (5%), rim e aparelho músculo-esquelético, nem sempre cursando com sintomatologia. A presença de envolvimento extratorácico afecta muitas vezes o prognóstico e a atitude terapêutica da sarcoidose.

Os autores fazem uma revisão das principais manifestações extratorácicas da sarcoidose, abordando as suas manifestações clínicas, diagnóstico, tratamento, seguimento e prognóstico.

Rev Port Pneumol 2008; XIV (1): 127-140

Palavras-chave:
Sarcoidose
extratorácica
Abstract

Sarcoidosis is a multisystemic granulomatous disease of unknown aetiology, characterized by the presence of non-caseating epithelioid cell granulomas on tissue biopsy of affected organs. It may involve any organ, presenting in multiple forms to clinicians of different specialities.

In its extra-thoracic form it may involve the liver (50-80%), spleen (40-80%), eye (20-50%), extrathoracic lymph nodes (30%), skin (25%), nervous system (10%), heart (5%), kidney, muscle and bone, sometimes without symptoms. The presence of extrathoracic disease may affect the prognosis and treatment options for sarcoidosis.

The authors present a review of the major extra-thoracic manifestations of sarcoidosis regarding its clincal presentation, diagnosis, treatment, follow-up and prognosis.

Rev Port Pneumol 2008; XIV (1): 127-140

Key-words:
Sarcoidosis
extra-thoracic
Full text is only aviable in PDF
Bibliografia
[1.]
U. Costabel.
Sarcoidosis: clinical update.
Eur Respir J, 18 (2001), pp. 56s-68s
[2.]
U. Costabel, G.W. Hunninghake.
ATS/ERS/WASOG statement on sarcoidosis.
Eur Respir J, 14 (1999), pp. 735-737
[3.]
R.D. Moller.
Rare manifestations of sarcoidosis.
Eur Respir Mon, 32 (2005), pp. 233-250
[4.]
D.G. James, S. Sherlock.
Sacoidosis of the liver.
Sarcoidosis, 11 (1994), pp. 2-6
[5.]
R. Vatti, O.P. Sharma.
Course of asymptomatic liver involvement in sarcoidosis: role of therapy in selected cases.
Sarcoidosis Vasc Diffuse Lung Dis, 14 (1997), pp. 73-76
[6.]
H.L. Israel, L.A. Goldstein.
Hepatic granulomatosis and sarcoidosis.
Ann Intern Med, 79 (1973), pp. 669-678
[7.]
J.M. Martín Santos.
Sarcoidosis.
Medicine, 8 (2001), pp. 1715-1722
[8.]
M.L. Padilla, G.J. Schilero, A.S. Teirstein.
Sarcoidosis and transplantation.
Sarcoidosis Vasc Diffuse Lung Dis, 14 (1997), pp. 16-22
[9.]
Luis A. Segorbe.
Sarcoidose.
Tratado de Pneumologia da Sociedade Portuguesa de Pneumologia, pp. 1327-1338
[10.]
Y.P. Katarina, M.E. Whitcomb.
Splenomegaly in sarcoidosis.
Arch Intern Med, 140 (1980), pp. 35-37
[11.]
A. Eklund, J. Grunewald.
Sarcoidosis.
Respiratory Medicine, 3rd Edition, pp. 1603-1620
[12.]
K. Ohara, M.A. Judson, R.P. Baughman.
Clinical aspects of ocular sarcoidosis.
Eur Respir Mon, 32 (2005), pp. 188-209
[13.]
M. Mayers.
Ocular sarcoidosis.
Int Ophtalmol Clin, 30 (1990), pp. 257-263
[14.]
D.A. Jabs, C.J. Johns.
Ocular involvement in chronic sarcoidosis.
Am J Ophtalmol, 102 (1986), pp. 297-300
[15.]
M.A. Judson, R.P. Baughman.
Sarcoidosis.
Diffuse Lung Disease A practical approach, pp. 109-129
[16.]
D.M. Warshauder, S.A. Dumbleton, P.L. Molina, et al.
Abdominal CT findings in sarcoidosis: radiological and clinical correlation.
[17.]
A. Eklund, G. Rizzato.
Skin manifestations in sarcoidosis.
Eur Respir Mon, 32 (2005), pp. 150-163
[18.]
J. Mana, J. Marcoval, J. Graells, et al.
Cutaneous involvement in sarcoidosis.
Arch Dermatol, 133 (1997), pp. 882-888
[19.]
G. Russo, L.E. Millikan.
Cutaneous sarcoidosis: diagnosis and treatment.
Comp Ther, 20 (1994), pp. 418-421
[20.]
G. Volden.
Successful treatment of chronic skin diseases with clobetasol propionate and a hydrocolloid occlusive dressing.
Acta Derm Venereol, 72 (1992), pp. 69-71
[21.]
L.S. Newman, C.S. Rose, L.A. Maier.
Sarcoidosis.
N Engl J Med, 336 (1997), pp. 1224-1234
[22.]
J.A. Zic, D.H. Horowitz, C. Arzubiaga, et al.
Treatment of cutaneous sarcoidosis with chloroquine.
Arch Dermatol, 127 (1991), pp. 1034-1040
[23.]
E. Jones, J.F. Callen.
Hydroxychloroquine is effective therapy for control of cutaneous sacoidal granulomas.
J Acad Dermatol, 23 (1990), pp. 487-489
[24.]
G.F. Webster, L.K. Razki, M. Sanchez, et al.
Weekly low-dose methotrexate therapy for cutaneous sarcoidosis.
J Am Acad Dermatol, 24 (1991), pp. 451-454
[25.]
J.L. Pollock.
Sarcoidosis responding to allopurinol.
Arch Dermatol, 116 (1980), pp. 273-274
[26.]
M. Carlesimo, S. Guistini, A. Rossi, et al.
Treatment of cutaneous and pulmonary sarcoidosis with thalidomide.
J Am Acad Dermatol, 32 (1995), pp. 866-869
[27.]
E. Hoitsma, O.P. Sharma.
Neurosarcoidosis.
Eur Respir Mon, 32 (2005), pp. 164-187
[28.]
O.P. Sharma.
Cardiac and neurologic dysfunction in sarcoidosis.
Clin Chest Med, 18 (1997), pp. 813-825
[29.]
B.J. Stern, A. Krumholz, C. Johns, et al.
Sarcoidosis and its neurological manifestations.
Arch Neurol, 42 (1985), pp. 909-917
[30.]
B.N. Agbogu, B.J. Stern, C. Sewell, et al.
Therapeutic considerations in patients with refractory neurosarcoidosis.
Arch Neurol, 52 (1995), pp. 875-879
[31.]
W. Schulte, D. Kirsten, M. Drent, U. Costabel.
Cardiac involvement in sarcoidosis.
Eur Respir Mon, 32 (2005), pp. 130-149
[32.]
M. Sekiguchi, Y. Yazaki, M. Isobe, et al.
Cardiac sarcoidosis: diagnostic, prognostic and therapeutic considerations.
Cardiovasc Drugs Ther, 10 (1996), pp. 495-510
[33.]
R.P. Baughman, E.E. Lower.
Steroid sparing alternative treatments for sarcoidosis.
Clin Chest Med, 18 (1997), pp. 853-864
[34.]
R.L. Shammas, A. Movahed.
Sarcoidosis of the heart.
Clin Cardiol, 16 (1993), pp. 462-472
[35.]
B.B. Chin, A.C. Civelek, A. Mudun.
Resting T-201 scintigraphy in the evaluation of myocardial sarcoidosis.
Clin Nucl Med, 22 (1997), pp. 475-478
[36.]
R.H. Winterbauer, S.H. Kirtland, D.E. Corley.
Treatment with corticosteroids.
Clin Chest Med, 18 (1997), pp. 843-851
[37.]
O.P. Sharma.
Renal sarcoidosis and hypercalcaemia.
Eur Respir Mon, 32 (2005), pp. 220-232
[38.]
O.P. Sharma.
Vitamin D, calcium and sarcoidosis.
Chest, 109 (1996), pp. 535-539
[39.]
U. Costabel, H. Teschler.
Biochemical changes in sarcoidosis.
Clin Chest Med, 18 (1997), pp. 827-842
[40.]
J.S. Adams, M.M. Diz, O.P. Sharma.
Effective reduction in the serum 1,25-hydroxyvitamin D and calcium concentration in sarcoidosis associated hypercalcaemia with short-course chloroquine therapy.
Ann Intern Med, 111 (1989), pp. 437-438
[41.]
M.J. Bia, K. Insogna.
Treatment of sarcoidosis associated hypercalcaemia with ketoconazole.
Am J Kidney Dis, 18 (1991), pp. 702-705
[42.]
T.L.T.A. Jansen, P.P.M.M. Geusens.
Sarcoidosis: joint, muscle and bone involvement.
Eur Respir Mon, 32 (2005), pp. 210-219
[43.]
T. Petterson.
Rheumatic features of sarcoidosis.
Curr Opin Rheumatol, 10 (1998), pp. 73-78
[44.]
T.J. Gran, E. Bohmer.
Acute sarcoid arthritis: a favourable outcome?.
Scan J Rheumatol, 25 (1996), pp. 70-73
[45.]
E. Neville, A.N. Walker, D.G. James.
Prognostic factors, predicting the outcome of sarcoidosis: an analysis of 818 patients.
Q J Med, 208 (1983), pp. 525-533
[46.]
O. Kaye, E. Palazzo, M. Grossin, et al.
Low-dose methotrexate: an effective corticosteroid-sparing agent in musculoskeletal manifestations of sarcoidosis.
Br J Rheumatol, 34 (1995), pp. 642-644
[47.]
M.A. Judson, R.P. Baughman, A.S. Terstein, et al.
Defining organ involvement in sarcoidosis: the ACCESS proposed instrument.
Sarcoidosis Vasc Diffuse Lung Dis, 16 (1999), pp. 75-86
[48.]
D. Kennedy, M. Yamakido.
Haematologic manifestations of sarcoidosis.
Semin Respir Med, 13 (1992), pp. 455-458
[49.]
P.M. Browne, O.P. Sharma, D. Salkin.
Bone marrow sarcoidosis.
JAMA, 240 (1978), pp. 2654-2655
[50.]
J.S. Bower, J.E. Belen, J.G. Weg, et al.
Manifestations and treatment of laryngeal sarcoidosis.
Am Rev Respir Dis, 122 (1980), pp. 325-332
[51.]
Y.P. Krespi, D.B. Kuriloff, M. Aner.
Sarcoidosis of the sinonasal tract: a new staging system.
Otolaryngol Head Neck Surg, 112 (1995), pp. 221-227
[52.]
U.K. Shah, J.A. White, J.E. Gooey, et al.
Otolaryngologic manifestations of sarcoidosis: presentation and diagnosis.
Laryngoscope, 107 (1997), pp. 67-75
[53.]
E.A. Scheffield.
Pathology of sarcoidosis.
Clin Chest Med, 18 (1997), pp. 741-754
Copyright © 2008. Sociedade Portuguesa de Pneumologia/SPP
Pulmonology
Article options
Tools

Are you a health professional able to prescribe or dispense drugs?