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要旨 神経・筋サルコイドーシスの診断基準が改訂された。検査項目として6つが挙げられ,そのうち2つ以上を満たすことが大切である。これには両側肺門リンパ節腫脹,67Ga集積像,気管支肺胞洗浄液の所見,血清ACE上昇,ツベルクリン反応陰性,血清カルシウムまたは尿中カルシウム増加が挙げられる。また組織診断群(definite),臨床診断群(probable)と臨床診断群(possible)に分けられた。このうちdefiniteとprobableの症例は神経・筋サルコイドーシスと診断して良いと思われる。またpossibleはサルコイドーシスの可能性があり,今後臨床ならびに検査でフォローしていくべき症例と考えられる。
We have collaborated with Japanese Sarcoidosis Society and Japanese Society of Respiratory Disease to provide a new diagnostic criteria of neurosarcoidosis.
At least two of six examinations are important. These include bilateral hilar lymphadenopathy, abnormal uptake of 67Ga scintigraphy, broncho alveolar lavage fluid examination, elevated serum ACE, negative tuberculin reaction, and elevated serum or urinary calcium level.(definite)Having positive clinical findings which suggest a neurosarcoidosis. Pathology proven case.(probable)Having positive clinical findings which suggest a neurosarcoidosis. Pathology proven in other organ. At least two of six examinations are positive.(possible) Having positive clinical findings which suggest a neurosarcoidosis. At least two of six examinations are positive.
CNS sarcoidosis, sarcoid neuronopathy and sarcoid myopathy are separately diagnosed. Kveim reaction which is time consuming, not so specific, and difficult to obtain its antigen is no more necessary.
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