Tratamiento de la Sarcoidosis

Tratamiento de la Sarcoidosis

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Marc A. Judson
Álvaro Morales


El tratamiento de la sarcoidosis no es mandatorio, ya que la enfermedad puede permanecer asintomática, sin compromiso o daño orgánico y puede resolverse sin medicamentos. La definición de tratamiento dependerá de la aparición de síntomas importantes o disfunción orgánica. Los corticosteroides son los medicamentos de elección y los fármacos adyuvantes o ahorradores de esteroides deben considerarse en caso de detectar efectos colaterales importantes o prolongación de su administración.

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Lynch JP 3rd, Kazerooni EA, Gay SE. Pulmonary sarcoidosis. Clin Chest Med 1997; 18: 755-85.

Mana J, Salazar A, Manresa F. Clinical factors predicting persistence of activity in sarcoidosis: a multivariate analysis of 193 cases. Respiration 1994; 61: 219-25.

Judson MA. An approach to the treatment of pulmonary sarcoidosis with corticosteroids: the six phases of treatment. Chest 1999; 115: 1158-65.

Gibson GJ, Prescott RJ, Muers MF, et al. British Thoracic Society Sarcoidosis study: effects of long-term corticosteroid treatment. Thorax 1996; 51: 238-47.

Winterbauer RH, Kirtland SH, Corley DE. Treatment with corticosteroids. Clin Chest Med 1997; 18: 843-51.

Gottlieb JE, Israel HL, Steiner RM, et al. Outcome in sarcoidosis: the relationship of relapse to corticosteroid therapy. Chest 1997; 111: 623-31.

Hunninghake GW, Costabel U, Ando M, et al. ATS/ERS/WASOG statement on sarcoidosis. American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and other Granulomatous Disorders. Sarcoidosis Vasc Diffuse Lung Dis 1999; 16: 149-73.

Drummond MB, Schwartz PF, Duggan WT, et al. Intersession variability in single-breath diffusing capacity in diabetics without overt lung disease. Am J Respir Crit Care Med 2008; 178: 225-32.

Judson MA, Gilbert GE, Rodgers JK, et al. The utility of the chest radiograph in diagnosing exacerbations of pulmonary sarcoidosis. Respirology 2008; 13: 97-102.

Drent M, Costabel U, Shipley R, et al. Changes of chest roengtenogram during double blind randomized trial of infliximab for chronic pulmonary sarcoidosis. Eur Respir J 2006; 28(Suppl 50): 111S.

Mana J, Teirstein AS, Mendelson DS, et al. Excessive thoracic computed tomographic scanning in sarcoidosis. Thorax 1995; 50: 1264-66.

Brenner DJ, Hall EJ. Computed tomography: an increasing source of radiation exposure. N Engl J Med 2007; 357: 2277-84.

Sheffield EA. Pathology of sarcoidosis. Clin Chest Med 1997; 18: 741-54.

Finkel R, Teirstein AS, Levine R, et al. Pulmonary function tests, serum angiotensinconverting enzyme levels, and clinical findings as prognostic indicators in sarcoidosis. Ann NY Acad Sci 1986; 465: 665-71.

Lower EE, Baughman RP. Prolonged use of methotrexate for sarcoidosis. Arch Intern Med 1995; 155: 846-51.

Baltzan M, Mehta S, Kirkham TH, et al. Randomized trial of prolonged chloroquine therapy in advanced pulmonary sarcoidosis. Am J Respir Crit Care Med 1999; 160: 192-7

Baughman RP, Drent M, Kavuru M, et al. Infliximab therapy in patients with chronic sarcoidosis and pulmonary involvement. Am J Respir Crit Care Med 2006; 174: 795-802.

Johns CJ, Michele TM. The clinical management of sarcoidosis: a 50-year experience at the Johns Hopkins Hospital. Medicine (Baltimore) 1999; 78: 65-111.

Handa T, Nagai S, Miki S, et al. Incidence of pulmonary hypertension and its clinical relevance in patients with sarcoidosis. Chest 2006; 129: 1246-52.

Judson MA. The management of sarcoidosis by the primary care physician. Am J Med 2007; 120: 403-7.

Ohara K, Judson MA, Baughman RP. Clinical aspects of ocular sarcoidosis. Eur Respir Mon 2005; 32: 188-209.

Dev S, McCallum RM, Jaffe GJ. Methotrexate treatment for sarcoid-associated panuveitis. Ophthalmology 1999; 106: 111-8.

Baughman RP, Lower EE. Leflunomide for chronic sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2004; 21: 43-8.

Baughman RP, Bradley DA, Lower EE. Infliximab in chronic ocular inflammation. Int J Clin Pharmacol Ther 2005; 43: 7-11.

Bradley D, Baughman RP, Raymond L, et al. Ocular manifestations of sarcoidosis. Semin Respir Crit Care Med 2002; 23: 543-8.

Mayers M. Ocular sarcoidosis. Int Ophthalmol Clin 1990; 30: 257-63.

Marchall R, Thiers B, Judson MA. Sarcoidosis. In: Wolff K, Goldsmith LA, Katz SI, et al, eds. Fitzpatrick’s dermatology in general medicine. New York, NY: McGraw Hill Medical, 2008; 1484-93.

Sharma OP. Vitamin D, calcium, and sarcoidosis. Chest 1996; 109: 535-9.

Bell NH, Stern PH, Pantzer E, et al. Evidence that increased circulating 1-alpha, 25- dihydroxyvitamin D is the probable cause for abnormal calcium metabolism in sarcoidosis. J Clin Invest 1979; 64: 218-25.

Sharma OP. Renal sarcoidosis and hypercalcaemia. Eur Respir Mon 2005; 32: 220-32.

Adams JS, Diz MM, Sharma OP. Effective reduction in the serum 1,25-dihydroxyvitamin D and calcium concentration in sarcoidosis-associated hypercalcemia with short-course chloroquine therapy. Ann Intern Med 1989; 111: 437-8.

Barre PE, Gascon-Barre M, Meakins JL, et al. Hydroxychloroquine treatment of hypercalcemia in a patient with sarcoidosis undergoing hemodialysis. Am J Med 1987; 82: 1259-62.

Conron M, Beynon HL. Ketoconazole for the treatment of refractory hypercalcemic sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2000; 17:277-80.

Stern BJ, Krumholz A, Johns C, et al. Sarcoidosis and its neurological manifestations. Arch Neurol 1985; 42: 909-17.

Sharma OP, Sharma AM. Sarcoidosis of the nervous system: a clinical approach. Arch Intern Med 1991; 151: 1317-21.

Ferriby D, de Seze J, Stojkovic T, et al. Long-term follow-up of neurosarcoidosis. Neurology 2001; 57: 927-9.

Zajicek JP, Scolding NJ, Foster O, et al. Central nervous system sarcoidosis: diagnosis and management. QJM 1999; 92: 103-17.

Oksanen V. Neurosarcoidosis: clinical presentations and course in 50 patients. Acta Neurol Scand 1986; 73: 283-90.

Sharma OP. Neurosarcoidosis: a personal perspective based on the study of 37 patients. Chest 1997; 112: 220-8.

Lower EE, Broderick JP, Brott TG, et al. Diagnosis and management of neurological sarcoidosis. Arch Intern Med 1997; 157: 1864-8.

Sharma OP. Effectiveness of chloroquine and hydroxychloroquine in treating selected patients with sarcoidosis with neurological involvement. Arch Neurol 1998; 55: 1248-1254.

Agbogu BN, Stern BJ, Sewell C, et al. Therapeutic considerations in patients with refractory neurosarcoidosis. Arch Neurol 1995; 52: 875-9.

Doty JD, Mazur JE, Judson MA. Treatment of corticosteroid-resistant neurosarcoidosis with a short-course cyclophosphamide regimen. Chest 2003; 124: 2023-6.

Stern BJ, Schonfeld SA, Sewell C, et al. The treatment of neurosarcoidosis with cyclosporine. Arch Neurol 1992; 49: 1065-72.

Doty JD, Mazur JE, Judson MA. Treatment of sarcoidosis with infliximab. Chest 2005; 127:1064-71.

Huang CT, Heurich AE, Sutton AL, et al. Mortality in sarcoidosis: a changing pattern of the causes of death. Eur J Respir Dis 1981; 62: 231-8.

Yazaki Y, Isobe M, Hiroe M, et al. Prognostic determinants of long-term survival in Japanese patients with cardiac sarcoidosis treated with prednisone. Am J Cardiol 2001; 88: 1006-10.

Sharma OP, Maheshwari A, Thaker K. Myocardial sarcoidosis. Chest 1993; 103 :253-8.

Chapelon-Abric C, de Zuttere D, Duhaut P, et al. Cardiac sarcoidosis: a retrospective study of 41 cases. Medicine (Baltimore) 2004; 83: 315-34.

Uemura A, Morimoto S, Hiramitsu S, et al. Histologic diagnostic rate of cardiac sarcoidosis: evaluation of endomyocardial biopsies. Am Heart J 1999; 138: 299-302.

Chin BB, Civelek AC, Mudun A. Resting Tl-201 scintigraphy in the evaluation of myocardial sarcoidosis. Clin Nucl Med 1997; 22: 475-8.

Nakazawa A, Ikeda K, Ito Y, et al. Usefulness of dual 67Ga and 99mTc-sestamibi single-photon-emission CT scanning in the diagnosis of cardiac sarcoidosis. Chest 2004; 126: 1372-6.

Vignaux O, Dhote R, Duboc D, et al. Clinical significance of myocardial magnetic resonance abnormalities in patients with sarcoidosis: a 1-year follow-up study. Chest 2002; 122: 1895-901.

Okumura W, Iwasaki T, Toyama T, et al. Usefulness of fasting 18F-FDG PET in identification of cardiac sarcoidosis. J Nucl Med 2004; 45: 1989-98.

Sekiguchi M, Yazaki Y, Isobe M, et al. Cardiac sarcoidosis: diagnostic, prognostic, and therapeutic considerations. Cardiovasc Drugs Ther 1996; 10: 495-510.

Judson MA. Extrapulmonary sarcoidosis. Semin Respir Crit Care Med 2007; 28: 83-101.

Roberts SD, Wilkes DS, Burgett RA, et al. Refractory sarcoidosis responding to infliximab. Chest 2003; 124: 2028-31.

Deng JC, Baughman RP, Lynch JP III. Cardiac involvement in sarcoidosis. Semin Respir Crit Care Med 2002; 23: 513-27.

Smedema JP, Snoep G, van Kroonenburgh MP, et al. Cardiac involvement in patients with pulmonary sarcoidosis assessed at two university medical centers in the Netherlands. Chest 2005; 128: 30-5.

Becheur H, Dall’osto H, Chatellier G, et al. Effect of ursodeoxycholic acid on chronic intrahepatic cholestasis due to sarcoidosis. Dig Dis Sci 1997; 42: 789-91.

Sharma OP. Sarcoidosis of the upper respiratory tract: selected cases emphasizing diagnostic and therapeutic difficulties. Sarcoidosis Vasc Diffuse Lung Dis 2002; 19: 227-33.

Hammond BL, Kataria YP. Nasal sarcoidosis with septal perforation. J Otolaryngol 1980; 9: 31-4.

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