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サルコイドニューロパチーは,原因不明の末梢神経障害で鑑別に挙げられる機会の多い疾患である。診断マーカーを欠くことから本症の鑑別診断はしばしば困難で,また多彩な臨床像を呈することが明らかとされており,「らしさ」をていねいに評価することで症例ごとに検査計画を立てていくことが求められる。神経サルコイドーシスの診断基準を一部修正して作成した,サルコイドニューロパチーの診断基準を紹介した。
Abstract
Sarcoid neuropathy, a rare condition which is seen in 1% of patients with sarcoidosis, often emerges as one of the differential diagnoses of neuropathies with an unknown origin. Recent studies have revealed that sarcoid neuropathy shows a broader spectrum of clinical characteristics than previously expected, including a Guillain-Barré- or chronic inflammatory demyelinating polyneuropathy-like presentation, small fiber neuropathy, and typical subacute multiple mononeuropathy. This makes the diagnosis difficult in certain cases. Due to the lack of diagnostic markers for this condition, neurological, laboratory, neurophysiological, and image analyses are all necessary to evaluate the probability of sarcoid neuropathy during differential diagnosis. This review mentions several cues for guiding the diagnosis, and diagnostic criteria.
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