伴有高钙血症、鼻窦炎和下丘脑-垂体功能障碍的系统性肉瘤病。

IF 1.6 4区 医学 Q2 Medicine Acta Clinica Belgica Pub Date : 2024-06-01 Epub Date: 2024-06-27 DOI:10.1080/17843286.2024.2366714
Anna Vander Heyde, Carl Gysbrechts, Anne-Marie Van der Biest
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引用次数: 0

摘要

目的:肉样瘤病是一种原因不明的多系统肉芽肿性疾病。它主要被认为是一种肺部疾病,但可影响任何器官系统。方法:我们在此描述一例年轻的白种男子,他曾因鼻窦炎、勃起功能障碍和厌食症就诊于多家医疗机构。他因发热、消瘦、多尿和多饮而到急诊科就诊。抽血结果显示他患有高钙血症和甲状腺功能异常:结果:经过生化、放射和组织病理学检查,他被诊断为肺肉样瘤病。使用皮质类固醇治疗后,鼻窦炎得到缓解,血钙和甲状腺功能恢复正常,但阳痿、多饮、多尿等症状依然存在。研究结果表明,肉样瘤累及肺外,下丘脑-垂体轴功能失调,伴有性腺功能减退症和因蝶鞍肿块引起的尿崩症:这是一例罕见的全身性肉样瘤病,同时伴有胸廓和胸廓外表现,并累及垂体和鼻窦。这表明肉样瘤病可累及任何器官系统,如果出现肺外表现,诊断可能会很困难。
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Systemic sarcoidosis presenting with hypercalcemia, sinusitis and hypothalamic-pituitary dysfunction.

Objectives: Sarcoidosis is a multi-system granulomatous disease of unknown origin. It is mainly thought of as a lung disease but it can affect any organ system. Sinus and endocrine dysfunctions are described but are rare and seldomly linked with sarcoidosis.

Methods: Here we describe a case of a young Caucasian man who already visited multiple care givers for sinusitis, erectile dysfunction and anorexia. He presented at the emergency department with fever and emaciation, polyuria and polydipsia. The results of the blood sampling revealed a hypercalcaemia as well as abnormal thyroid function.

Results: After biochemical, radiological and histopathological workup, he was diagnosed with pulmonary sarcoidosis. Treatment with corticosteroids resulted in resolution of the sinusitis and normalisation of the calcemia, as well as the thyroid function while the impotence, polydipsia and polyuria remained. Elaboration revealed extra-pulmonary involvement of the sarcoidosis with dysfunction of the hypothalamic-pituitary axis with hypogonadotropic hypogonadism and diabetes insipidus due to a sellar mass.

Conclusion: This is a rare case of systemic sarcoidosis with both thoracic and extra thoracic manifestations, with pituitary and sinus involvement. It shows that sarcoidosis can affect any organ system and diagnosis can be difficult in case of extrapulmonary manifestations.

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来源期刊
Acta Clinica Belgica
Acta Clinica Belgica 医学-医学:内科
CiteScore
2.90
自引率
0.00%
发文量
44
审稿时长
6-12 weeks
期刊介绍: Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.
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