Methods of treating sarcoidosis


  • Treatment of sarcoidosis corticosteroids
  • Treatment of sarcoidosis by physiotherapeutic methods
  • Treatment and forecasts

  • Treatment of sarcoidosis corticosteroids

    All methods of treating sarcoidosis
    based on the suppression of inflammatory reactions and preventing
    Fibrous transformation granuloma. Today the most effective
    The treatment of sarcoidosis therapy is corticosteroids that
    have a powerful anti-inflammatory effect, overwhelming
    Immunoglobulins, interleukins and other inflammation mediators.

    The question of the testimony to the beginning of corticosteroid therapy is not resolved
    Definite. In accordance with one extreme point of view, the presence
    active inflammatory process and the possibility of forming
    irreversible fibrous changes in organs require treatment
    Immediately after the diagnosis. On the other hand, high
    The probability of spontaneous regression with complete resampling
    changes and the likelihood of complications from treatment do
    Inappropriate early start of treatment in all cases. Cause
    difficulties in determining therapeutic tactics is that
    most patients in identifying the disease can not be reliably
    predict his further flow.

    Absolute testimony for immediate start of treatment are
    the presence of lesion of the heart and eye due to the risk of development of dangerous for
    life of complications and loss of vision.

    It is also advisable to appoint
    Corticosteroids in cases:

    • acute start of sarcoidosis with high activity
      inflammatory process manifested by polyarthritis and noded
    • significant, progressive lesion of pulmonary fabric with pronounced disorders of the respiratory function;
    • Combining Sarcoidosis of respiratory organs with any extrap
      localizations when the probability of progressive or
      recurrent flow;
    • Sarcoidosis recurrences with severe clinical manifestations and functional disorders.

    In other cases, especially with the primary identification of sarcoidosis,
    The question of the need for treatment is solved after 3 - 6 months of observation

    Corticosteroid therapy is usually carried out for a long time: within 6 -
    8 months. Short (3-month) treatment courses are not enough for
    Achievements of the rescue, and the probability of relapse is essential
    increases. The dose of corticosteroids used in sarcoidosis varies
    from 20 to 80 mg of equivalent prednisolone per day. Optimal with a point
    vision of the ratio of efficiency and side effects of treatment is
    Initial daily dose 25 - 30 mg. After 40 - 60 days daily
    reception of drugs in 70 - 80% of patients is determined by distinct
    Positive dynamics expressed in clinical improvement and
    Reduction of changes in lungs and vgl on radiographs. Frequency
    Moderately pronounced side manifestations of corticosteroid therapy
    usually does not exceed 15%. Intermitting (every other day) Reception 25 - 30 mg
    Corticosteroids allows you to achieve improvement somewhat later - after 2 - 3 months, but the frequency and severity of side effects of treatment
    decrease by 1.5 - 2 times.

    Methods of treating sarcoidosis
    After registration positive
    The effect of the started corticosteroid therapy is possible to transition from
    daily reception of the drug on an intermitting, dose gradually
    Reduce to complete cancellation and continue to monitor patients. It is advisable to use corticoserous drugs,
    Possessing the best tolerance (methylprednisolone, triamxinolone,
    Betamethasone). Corticosteroids are advisable to combine with drugs
    potassium, if necessary, use known means for correction
    Side manifestations of treatment.

    Other treatments for sarcoidosis can be viewed as
    Alternative or addition to basic therapy system
    corticosteroids in cases where there are contraindications or
    Restrictions for its application.

    The results of use in sarcoidosis of inhalation
    Corticosteroids (Becmetazone Dipropionate, Flunicolida, Flicazone)
    Estimated ambiguously. Undoubted appropriate destination
    local action drugs in cases of damage to the mucosa,
    which are detected in 20% of patients. At the same time, the lack of system
    actions avoiding many complications at the same time reduces
    Therapeutic effect of topical steroids.

    Santeroids are also used to treat sarcoidosis
    Anti-inflammatory funds (delagil, placmenyl), antioxidants
    treatment is significantly more modest results of system corticosteroid

    Preventive course of anti-tuberculosis therapy (usually
    Gink preparations) simultaneously with corticosteroids it is advisable
    prescribe only sarcoidosis patients who have residual
    Postatuberculosis changes.

    Treatment of sarcoidosis by physiotherapeutic methods

    In the treatment of patients with sarcoidosis, a series is successfully used
    non-drug methods. Unloading and dietary therapy has
    powerful immunosuppressive action, and also stimulates the function
    adrenal glands.

    According to M.M.Ilkovich and Sowa., Positive effect after 2 weeks.
    Full starvation and subsequent weekly reducing period
    It is observed in 30 - 80% of patients depending on the stage of the disease.

    Effective physiotherapeutic method for sarcoidosis is
    EFC-therapy. Course from 20 procedures for the effect of wavelength 5.6, 6.4 or
    7.1 mm on the area of ​​the fork gland allows to achieve improvement
    active for the first time identified sarcoidosis or recurrence of the disease. More
    Effectively combination of KVF-therapy with reduced doses (10 - 15
    mg / day) corticosteroids.

    Good results of treating patients with sarcoidosis gives
    Plasmapheresis, the action of which is based on removal with plasma
    Inflammatory mediators, immune complexes, improvement of microcirculation.
    Plasmapheresis is shown in the insufficient basis effect
    corticosteroid therapy or in cases of limited
    conduct (for example, in patients with diabetes mellitus, severe arterial
    Hypertension, ulcerative disease). Different modes have been proposed
    Plasmalresa. Good results were obtained during the course of 3 - 4
    Plasmapheresses of 700 - 800 ml with an interval of 5 - 7 days.

    The effect of treatment with good tolerance is significantly
    Increases with a combination of plasmapheresis with small doses (10 - 15
    mg / day) corticosteroids.

    Treatment and forecasts

    The stay of patients with sarcoidosis in the hospital is limited to their term
    Surveys to establish a diagnosis and evaluation of tolerance
    prescribed treatment (usually from 1 to 1.5 months). Well
    unloading and dietary therapy and invasive treatment methods also
    must be carried out in the clinic. Treatment is continued in outpatient
    conditions. With satisfactory well-being of patients and good
    Patient treatment tolerance is not contraindicated by labor activity.

    Methods of treating sarcoidosis
    Sarcoidosis in most cases favorable: in 20%
    Patients occurs spontaneous regression, half after the course
    treatment is not observed relapses. The recurrent course is noted
    25%, and progressive - only 5% of patients.

    Over the years, survey and monitor patients
    Sarcoidosis in our country was carried out mainly on the basis
    Anti-tuberculosis institutions. In accordance with the activity
    Diseases of patients with sarcoidosis refer to one of the three subgroups VIII
    Groups of dispensary tuning of anti-tuberculous dispensaries. Subgroup
    Examination, including medical examination, radiography, clinical
    blood test and spirography, repeat every 3 months during the first
    years and every 6 months during the second year of observation. In the subgroup
    VIII-B include patients with relapses and progressive current

    Patients of this subgroup receiving corticosteroid therapy,
    Watch back quarterly. Patients VIII-in subgroups (with inactive
    Sarcoidosis) observe 1 time per year. In the absence of relapses on
    for 2 years they can be discontinued, however
    Sarcoidosis recurrences after many years of remission makes it appropriate
    longer observation of patients in the subgroup of VIII-in. Patients S
    Overlooking localizations of sarcoidosis also need observing
    specialists of the relevant profile.

    Thus, despite the fact that the etiology of sarcoidosis remains
    unidentified and many unsolved questions require further
    Study of this disease, diagnosis and treatment of sarcoidosis
    are well designed to provide patients
    Satisfactory level of quality of life.

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