Pulmonale Sarkoidose

ZUSAMMENFASSUNG

Die Sarkoidose ist in Nordeuropa die häufigste granulomatöse Erkrankung. Sie kann prinzipiell nahezu alle Organe betreffen. Die Lunge ist jedoch mit 90–95 % das am häufigsten betroffene Organ. Die pulmonale Sarkoidose kann von einem asymptomatischen Befall bis hin zu einer interstitiellen Fibrose mit schwer eingeschränkter Lungenfunktion auftreten. Mit dem konventionellen Röntgen wird die pulmonale Sarkoidose in 4 Typen unterteilt. Neben der Lungenfunktion ist der radiologische Befallstyp mit entscheidend für die Therapieindikation. Wichtige Bausteine in der Diagnostik sind neben der radiologischen Bildgebung die Bestimmung der Lungenfunktion sowie die Bronchoskopie zur histologischen Diagnosesicherung. Daneben muss bei möglichem Multiorganbefall eine umfangreiche Organdiagnostik zur Erfassung weiterer Organmanifestationen erfolgen. Die Therapie besteht an erster Stelle aus der Gabe von Glukokortikoiden sowie bei unzureichender Wirkung oder Steroid-induzierten Nebenwirkungen aus der zusätzlichen Gabe von Immunsuppressiva. Hier steht an vorderster Stelle eine Therapie mit Methotrexat (MTX).

ABSTRACT

Sarcoidosis is the most common granulomatous disease in Northern Europe. In principle, it can affect almost all organs. However, the lung is the most frequently affected organ at 90–95 %. Pulmonary sarcoidosis can range from asymptomatic involvement to interstitial fibrosis with severely impaired lung function. With conventional X-rays, pulmonary sarcoidosis is divided into 4 types. In addition to the lung function, the type of radiological involvement is also decisive for the indication for therapy. In addition to radiological imaging, important components in diagnostics are the determination of lung function and bronchoscopy for histological confirmation of the diagnosis. In addition, in the event of possible multi-organ involvement, extensive organ diagnostics must be carried out to record further organ manifestations. The therapy consists primarily of the administration of glucocorticoids and, in the case of insufficient effect or steroid-induced side effects, of the additional administration of immunosuppressants. Therapy with MTX is the first choice.

Schlüsselwörter

Sarkoidose - Lunge - Diagnostik - Therapie

Keywords

Sarcoidosis - lung - diagnostic - therapy

Publication History

Article published online:
05 November 2022

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