PDF(Pubmed)
Abstract：
Sarcoidosis is a systemic granulomatous disease characterized by the hyperactivation of CD4 T cells, CD8 T cells, and macrophages. Clinical presentations of sarcoidosis are highly variable. Sarcoidosis is unknown in its etiology, but it suggests it may result from exposure to specific environmental agents in genetically susceptible people. Sarcoidosis commonly involves the lungs and lymphoid system. Bone marrow involvement in sarcoidosis is uncommon. Sarcoidosis rarely results in intracerebral hemorrhage due to severe thrombocytopenia secondary to bone marrow involvement. We present the case of a 72-year-old woman who has been in remission from sarcoidosis for 15 years and developed intracerebral hemorrhage secondary to severe thrombocytopenia due to sarcoidosis recurrence in the bone marrow. The patient presented to the emergency department with a generalized, non-blanching petechiae rash and nose and gum bleeding. Her labs showed a platelet count of less than 10.000/mcL, and computed tomography (CT) showed intracerebral hemorrhage. A bone marrow biopsy revealed a small, non-caseating granuloma indicative of a sarcoidosis relapse in the bone marrow.
摘要：
结节病是一种以CD4T细胞过度活化为特征的全身性肉芽肿性疾病，CD8T细胞，和巨噬细胞。结节病的临床表现是高度可变的。结节病的病因不明，但它表明，这可能是由于暴露于遗传易感人群的特定环境因素所致。结节病通常累及肺和淋巴系统。结节病的骨髓受累并不常见。结节病很少导致脑出血，因为严重的血小板减少继发于骨髓受累。我们介绍了一名72岁妇女的病例，该妇女已从结节病缓解了15年，并因骨髓结节病复发而继发于严重血小板减少症。病人被送到急诊科，不烫瘀点皮疹和鼻子和牙龈出血。她的实验室显示血小板计数低于10.000/mcL，计算机断层扫描（CT）显示脑出血。骨髓活检显示，非干酪样肉芽肿表明骨髓结节病复发。
