‹laca ba¤l› sarkoidoz
Anti-TNF ajanlar tedaviye dirençli sarkoidoz hastalar›-
n›n tedavisinde baflar›yla kullan›lsa da, sarkoidoz hastal›¤›
olmayan ve baflka nedenlerle anti-TNF ajanlar› kullanan
baz› hastalarda bu tedaviye ba¤l› sarkoidoz geliflebildi¤i de
bildirilmifltir.
[75]
Bunun mekanizmas› tam olarak bilinmese
de, anti-TNF tedavisi sonucunda TNF-
α ile IFN-α sito-
kinleri aras›ndaki dengenin bozulmas› ve sonuçta IFN-·
düzeyinin yükselmesi ile ilgili oldu¤u düflünülmektedir.
Gerçekten, IFN-
α tedavisinde de sarkoidoz ortaya ç›kabil-
mektedir. Anti-TNF tedavisi zemininde geliflen sarkoido-
zun, patogenetik süreç aç›s›ndan anti-TNF tedaviye ba¤l›
psoriyazis veya lupus tablosu ile de benzerlik gösterdi¤i
düflünülmektedir.
[76]
Prognoz
Ço¤u hastada spontan remisyon görülür (%60). Akut
sarkoidozlu hastalar spontan remisyona girme olas›l›klar›
daha fazlad›r. Löfgren sendromlu hastalar genellikle teda-
visiz ve spontan remisyona girerler; prognoz iyidir.
[46]
Sar-
koidoz hastalar›n›n %10-20’sinde KS tedavisi gerekir.
%10-30 olgu kronikleflir. Mortalite oran› %1-5 oran›nda
bildirilmifltir.
[77]
Tüm ölümlerin yar›s› ilerleyici pulmoner
hastal›k, di¤er yar›s› kardiyak/nörolojik hastal›k kaynakl›-
d›r. Tablo 3’te sarkoidozda kötü prognoz ile iliflkili özel-
likler gösterilmifltir.
[50]
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• Afrika kökenli Amerikal›lar
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- Dispne (orta-fliddetli)
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