Pulmonale Sarkoidose

Benedikt Jentzsch; Louis Jouanjan; Björn Christian Frye

doi:10.1055/a-2318-0007

Arthritis und Rheuma, Table of Contents

Arthritis und Rheuma 2024; 44(05): 305-317
DOI: 10.1055/a-2318-0007

Schwerpunkt

Pulmonale Sarkoidose

Authors

Benedikt Jentzsch

Klinik für Pneumologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg
Louis Jouanjan

Klinik für Pneumologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg
Björn Christian Frye

Klinik für Pneumologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg

Abstract

ZUSAMMENFASSUNG

Sarkoidose ist eine seltene, granulomatöse Erkrankung unklarer Ätiologie, die vor allem das lymphatische System und die Lunge befällt, jedoch auch alle anderen Organe betreffen kann. Die Diagnose wird anhand passender klinischer Symptome, dem histologischen Nachweis von nicht nekrotisierenden Granulomen sowie dem Ausschluss relevanter Differenzialdiagnosen gestellt. Der histologische Nachweis von Granulomen gelingt häufig mittels endobronchialer ultraschallgesteuerter transbronchialer Feinnadelbiopsie der thorakalen Lymphknoten, alternativ können bronchoskopisch Schleimhaut- oder transbronchiale Parenchymbiopsien zur Diagnose vorgenommen werden. Die Entscheidung für eine immunsuppressive Therapie sollte vor allem unter Berücksichtigung der Nebenwirkungen dann getroffen werden, wenn die Sarkoidose die Lebensqualität der*s Betroffenen reduziert oder Organfunktionen einschränkt. Die Therapie erfolgt primär mit Kortikosteroiden und kann in der Zweitlinientherapie um Azathioprin oder Methotrexat (oder andere DMARD) als steroidsparende Medikamente erweitert werden. Die klinische Verlaufskontrolle zielt auf das Monitoring der Organfunktionen (z. B. Lungenfunktion) und der Lebensqualität.

Schlüsselwörter

Granulomatöse Erkrankungen - gemischte Ventilationsstörung - Bronchoskopie - immunsuppressive Therapie

Full Text

References

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