Zusammenfassung
Die Sarkoidose ist eine multisystemische granulomatöse Autoimmunerkrankung unbekannter Ätiologie. Beobachtet wird eine gehäufte Assoziation mit bestimmten HLA-Genen (HLA-B8, HLA-DR17). Aufgrund der Immunreaktionen in den Frühphasen der Erkrankung vermutet man, dass bei einer entsprechenden genetischen Disposition infektiöse und nichtinfektiöse antigene Umgebungsfaktoren in den Zielorganen zu Aktivierung und Expansion von T-Zellen, insbesondere TH1-Zellen, führt, die die Immunreaktion initiieren.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
Literatur
Zu 33.1
ATS Board of Directors and by the ERS Executive Committee. Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG). February 1999. Am J Respir Crit Care Med 1999; 160:736–755
Barnard J, Newman LS. Sarcoidosis: immunology, rheumatic involvement, and therapeutics. Curr Opin Rheumatol 2001; 13: 84–91
Berger C, Sommer C, Meinck HM. Isolated sarcoid myopathy. Muscle Nerve 2002; 26:553–556
Bolat S, Berding G, Dengler R, StangelM, Trebst C. Fluorodeoxyglucose positron emission tomography (FDG-PET) is useful in the diagnosis of neurosarcoidosis. J Neurol Sci 2009; 287:257–259
Bunting PS, Szalai JP, Katic M. Diagnostic aspects of angiotensin converting enzyme in pulmonary sarcoidosis. Clin Biochem. 1987; 20: 213–219
Christoforidis GA, Spickler EM, Recio MV, Mehta BM. MR of CNS sarcoidosis: correlation of imaging features to clinical symptoms and response to treatment. AJNR Am J Neuroradiol 1999; 20: 655–669
Hayat GR, Walton TP, Smith KR Jr, Martin DS, Manepalli AN. Solitary intramedullary neurosarcoidosis: role of MRI in early detection. J Neuroimaging 2001; 11: 66–70
Hershcovici T, Mekhmandorov S, Beigel Y, Hardoff R. The value of Ga-67 scintigraphy in sarcoid myopathy. Clin Nucl Med. 2001; 26: 540–542
Hoitsma E, Faber CG, Drent M, Sharma OP. Neurosarcoidosis: a clinical dilemma. Lancet Neurol. 2004; 3: 397–407
Hoitsma E, Drent M, Sharma OP. A pragmatic approach to diagnosing and treating neurosarcoidosis in the 21st century. Curr Opin Pulm Med 2010; 16:472–479
Kramers C, Deinum J. Increased serum activity of angiotensinconverting enzyme (ACE): indication of sarcoidosis? A ‘Bayesian’ approach] Ned Tijdschr Geneeskd 2003; 147: 473–476
Leclerc S, Myers RP, Moussalli J, Herson S, Poynard T, Benveniste O. Sarcoidosis and interferon therapy: report of five cases and review of the literature. Eur J Intern Med 2003; 14: 237–243
Nowak DA, Widenka DC. Neurosarcoidosis: a review of its intracranial manifestation. J Neurol 2001; 248: 363–372
Reske D, Petereit HF, Heiss WD. Difficulties in the differentiation of chronic inflammatory diseases of the central nervous system – value of cerebrospinal fluid analysis and immunological abnormalities in the diagnosis. Acta Neurol Scand 2005; 112: 207–213
Roberts SD, Wilkes DS, Burgett RA, Knox KS. Refractory sarcoidosis responding to infliximab. Chest. 2003; 124: 2028–2031
Sohn HS, Kim EN, Park JM, Chung YA. Muscular sarcoidosis: Ga- 67 scintigraphy and magnetic resonance imaging. Clin Nucl Med 2001; 26: 29–32
Ulbricht KU, Stoll M, Bierwirth J, Witte T, Schmidt RE. Successful tumor necrosis factor alpha blockade treatment in therapyresistant sarcoidosis. Arthritis Rheum 2003; 48: 3542–3354
Walter MC, Lochmuller H, Schlotter-Weigel B, Meindl T, Muller-Felber W. Successful treatment of muscle sarcoidosis with thalidomide. Acta Myol 2003; 22: 22–25
Woitalla D, Henkes H, Felber S, Weber W, Janisch W, Kuhne D. Clinical aspects and diagnostic imaging in sarcoidosis of the nervous system. Radiologe 2000; 40: 1064–1076
Zettl UK, Lehmitz R, Mix E. Klinische Liquordiagnostik. de Gruyter 2003, Berlin, New York
Zu 33.2
ACR Ad Hoc Committee on Neuropsychiatric Lupus Nomenclature. The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus. Arthritis Rheum 1999; 42:599–608
Berlit P. Neuropsychiatric disease in collagen vascular diseases and vasculitis. J Neurol 2007; 254:II87–89
Berlit P. Diagnosis and treatment of cerebral vasculitis. Therapeutic Advances in Neurological Disorders 2010; 3:29–42
Carson KR, Evens AM, Richey EA, Habermann TM , Focosi D, Seymour JF , Laubach J , Bawn SD , Gordon LI, Winter JN, Furman RR , Vose JM , Zelenetz AD , Mamtani R , Raisch DW, Dorshimer GW , Rosen ST , Muro K , Gottardi-Littell NR, Talley RL, Sartor O, Green D, Major EO, Bennett CL. Progressive multifocal leukoencephalopathy after rituximab therapy in HIV-negative patients: a report of 57 cases from the Research on Adverse Drug Events and Reports project. Blood. 2009;113:4834–4840
Chan TM, Li FK, Tang CS, Wong RW, Fang GX, Ji YL, et al. Efficacy of mycophenolate mofetil in patients with diffuse proliferative lupus nephritis. Hong Kong-Guangzhou Nephrology Study Group. N Engl J Med 2000; 343:1156–1162
Hanly JG. ACR classification criteria for systemic lupus erythematosus: limitations and revisions to neuropsychiatric variables. Lupus 2004; 13:861–864
Harrison MJ, Ravdin LD, Lockshin MD. Relationship between serum NR2a antibodies and cognitive dysfunction in systemic lupus erythematosus. Arthritis Rheum 2006;54:2515–2522
Illei GG, Austin HA, Crane M, Collins L, Gourley MF, Yarboro CH, et al. Combination therapy with pulse cyclophosphamide plus pulse methylprednisolone improves long-term renal outcome without adding toxicity in patients with lupus nephritis. Ann Intern Med 2001; 135:248–257
Krämer M, Berlit P (2011) Systemic, secondary and infectious causes for cerebral vasculitis: clinical experience with 16 new European cases. Rheumatol Int, in press
Mok CC, Ho CT, Chan KW, Lau CS, Wong RW. Outcome and prognostic indicators of diffuse proliferative lupus glomerulonephritis treated with sequential oral cyclophosphamide and azathioprine. Arthritis Rheum 2002; 46:1003–1013
Morton SJ, Powell RJ. Management of systemic lupus erythematosus (SLE). Clin Exp Allergy 2001; 31:686–693
Mosca M, Ruiz-Irastorza G, Khamashta MA, Hughes GR. Treatment of systemic lupus erythematosus. Int Immunopharmacol 2001; 1:1065–1075
Ortmann RA, Klippel JH. Update on cyclophosphamide for systemic lupus erythematosus. Rheum Dis Clin North Am 2000; 26:363–375, vii
Ruiz-Irastorza G, Khamashta MA, Castellino G, Hughes GR. Systemic lupus erythematosus. Lancet 2001; 357:1027–1032
Sibbitt WL Jr., Sibbitt RR, Brooks WM. Neuroimaging in neuropsychiatric systemic lupus erythematosus. Arthritis Rheum 1999; 42:2026–2038
Takada K, Illei GG, Boumpas DT. Cyclophosphamide for the treatment of systemic lupus erythematosus. Lupus 2001; 10:154–161
Zu 33.3
Apak RA, Anlar B, Saatci I. A case of relapsing acute disseminated encephalomyelitis with high dose corticosteroid treatment. Brain Dev 1999; 21:279–282
Bizzi A, Ulug AM, Crawford TO, Passe T, Bugiani M, Bryan RN, Barker PB. Quantitative proton MR spectroscopic imaging in acute disseminated encephalomyelitis. AJNR Am J Neuroradiol 2001; 22:1125–1130
Dale RC, de Sousa C, Chong WK, Cox TC, Harding B, Neville BG. Acute disseminated encephalomyelitis, multiphasic disseminated encephalomyelitis and multiple sclerosis in children. Brain 2000; 123 Pt 12:2407–2422
Finsterer J, Grass R, Stollberger C, Mamoli B. Immunoglobulins in acute, parainfectious, disseminated encephalo-myelitis. Clin Neuropharmacol 1998; 21:258–261
Gupte G, Stonehouse M, Wassmer E, Coad NA, Whitehouse WP. Acute disseminated encephalomyelitis: a review of 18 cases in childhood. J Paediatr Child Health 2003; 39:336–342
Haase CG, Faustmann PM, Diener H. Idiopathic inflammatory demyelinating diseases of the central nervous system: differentiating between acute disseminated encephalomyelitis and malignant multiple sclerosis. J Clin Neurosci 1999; 6:221–226
Hahn CD, Miles BS, MacGregor DL, Blaser SI, Banwell BL, Hetherington CR. Neurocognitive outcome after acute disseminated encephalomyelitis. Pediatr Neurol 2003; 29:117–123
Hart MN, Earle KM. Haemorrhagic and perivenous encephalitis: a clinical-pathological review of 38 cases. J Neurol Neurosurg Psychiatry 1975; 38:585–591
Hurst EW. Acute haemorrhagic leuco-encephalitis, a previuosly undefined entity. Medical Journal of Australia 1941; 2:1–6
Inglese M, Salvi F, Iannucci G, Mancardi GL, Mascalchi M, Filippi M. Magnetization transfer and diffusion tensor MR imaging of acute disseminated encephalomyelitis. AJNR Am J Neuroradiol 2002; 23: 267–272
Ichiyama T, Shoji H, Kato M. Cerebrospinal fluid levels of cytokines and soluble tumour necrosis factor receptor in acute disseminated encephalomyelitis. Eur J Pediatr 2002; 161:133–137
Krupp LB, Banwell B, Tenembaum S, for the International Pediatric MS Study Group. Consensus definitions proposed for pediatric multiple sclerosis and related childhood disorders. Neurology 2007; 68 (Suppl 2):S7–S12
Kanter DS, Horensky D, Sperling RA, Kaplan JD, Malachowski ME, Churchill WH Jr. Plasmapheresis in fulminant acute disseminated encephalomyelitis. Neurology 1995;45:824–827
Markus R, Brew BJ, Turner J, Pell M. Successful outcome with aggressive treatment of acute haemorrhagic leukoencephalitis. J Neurol Neurosurg Psychiatry 1997 Oct; 63(4):551
Niedermayer I, Deinzer M, Moringlane JR, Feiden W. Neuropathological and neuroradiological aspects of acute disseminated encephalomyelitis (ADEM). Radiologe 2000; 40:1030–1035
Pasternak JF, De Vivo DC, Prensky AL. Steroid-responsive encephalomyelitis in childhood. Neurology 1980; 30:481–486
Pfausler B, Engelhardt K, Kampfl A, Spiss H, Taferner E, Schmutzhard E. Post-infectious central and peripheral nervous system diseases complicating Mycoplasma pneumoniae infection. Report of three cases and review of the literature. Eur J Neurol 2002; 9:93–96
Poser S, Luer W, Bruhn H, Frahm J, Bruck Y, Felgenhauer K. Acute demyelinating disease. Classification and non-invasive diagnosis. Acta Neurol Scand 1992; 86:579–585
Ravaglia S, Corso A, Piccolo G, Lozza A, Alfonsi E, Mangiacavalli S, Varettoni M, Zappasodi P, Moglia A, Lazzarino M, Costa A. Severe steroid-resistant postinfectious encephalomyelitis: general features and effects of IVIg. J Neurol 2007; 254:1518–1523
Schwarz S, Mohr A, Knauth M, Wildemann B, Storch-Hagenlocher B. Acute disseminated encephalomyelitis: a followup study of 40 adult patients. Neurology 2001; 56:1313–1318
Schwarz S, Knauth M, Mohr A, Wildemann B, Sommer C, Storch-Hagenlocher B. Acute disseminated encephalomyelitis (ADEM) Nervenarzt 2001; 72:241–254
Singh S, Alexander M, Korah IP. Acute disseminated encephalomyelitis: MR imaging features. AJR Am J Roentgenol 1999; 173:1101–1107
Sonneville R, Klein IF, Wolff M. Update on investigation and management of postinfectious encephalitis. Current Opinion in Neurology 2010; 23:300–304
Sugita K, Suzuki N, Shimizu N, Takanashi J, Ishii M, Niimi N. Involvement of cytokines in N-methyl-N’-nitro-Nnitrosoguanidine- induced plasminogen activator activity in acute disseminated encephalomyelitis and multiple sclerosis lymphocytes. Eur Neurol 1993; 33:358–362
Tenembaum S, Chamoles N, Fejerman N. Acute disseminated encephalomyelitis: a long-term follow-up study of 84 pediatric patients. Neurology 2002; 59:1224–1231
Tenembaum S, Chitnis T, Ness J, Hahn JS for the International Pediatric MS Study Group. Acute disseminated encephalomyelitis. Neurology 2007; 68(Suppl 2):S23–S36
Van Der Knaap MS, Valk J. Magnetic resonance of myelin, myelination, and myelin disorders, 2nd ed. Springer 1995, Berlin, Heidelberg, New York
Zettl UK, Lehmitz R, Mix E. Klinische Liquordiagnostik. de Gruyter 2003, Berlin, New York
Zu 33.4
Akman-Demir G, Serdaroglu P, Tasci B. Clinical patterns of neurological involvement in Behcet’s disease: evaluation of 200 patients. The Neuro-Behcet Study Group. Brain 1999; 122:2171–2182
Bartels E. Farbduplexsonographie der hirnversorgenden Gefäße. Schattauer 1999, Stuttgart, New York
Berlit P. The spectrum of vasculopathies in the differential diagnosis of vasculitis. Sem Neurol 1994; 14:370–379
Berlit P, Steinbrecher A. Zerebrale Vaskulitis. Fortschr Neurol Psych 2002; 70:663–677
Bartels E. Farbduplexsonographie der hirnversorgenden Gefäße. Schattauer 1999, Stuttgart, New York
Calabrese LH, Gragg LA, Furlan AJ Benign angiopathy. A distinct subset of angiographically defined primary angiitis of the CNS. J Rheumatol 1993; 20:2046–2050
Calabrese LH, Duna GF, Lie JT. Vasculitis in the central nervous system. Arthritis Rheum 1997; 40:1189–1201
de Groot K, Muhler M, Reinhold-Keller E, Paulsen J, Gross WL. Induction of remission in Wegener’s granulomatosis with low dose methotrexate. J Rheumatol 1998; 25:492–495
de Groot K, Reinhold-Keller E, Tatsis E, Paulsen J, Heller M, Nolle B, et al. Therapy for the maintenance of remission in sixty-five patients with generalized Wegener’s granulomatosis. Methotrexate versus trimethoprim/sulfamethoxazole. Arthritis Rheum 1996; 39:2052–2061
de Groot K, Schmidt DK, Arlt AC, Gross WL, Reinhold-Keller E. Standardized neurologic evaluations of 128 patients with Wegener granulomatosis. Arch Neurol 2001; 58:1215–1221
Fauci AS, Haynes BF, Katz P, Wolff SM. Wegener’s granulomatosis: prospective clinical and therapeutic experience with 85 patients for 21 years. Ann Intern Med 1983; 98:76–85
Gayraud M, Guillevin L, le Toumelin P, Cohen P, Lhote F, Casassus P. Long-term follow up of polyarteritis nodosa, microscopic polyangiitis, and Churg-Strauss syndrome: analysis of four prospective trials including 278 patients. Arthritis Rheum 2001; 44:666–675
Guillevin L, Cordier JF, Lhote F, Cohen P, Jarrousse B, Royer I. A prospective, multicenter, randomized trial comparing steroids and pulse cyclophosphamide versus steroids and oral cyclophosphamide in the treatment of generalized Wegener’s granulomatosis. Arthritis Rheum 1997; 40:2187–2198
Guillevin L, Lhote F, Cohen P, Sauvaget F, Jarrousse B, Lortholary O, et al. Polyarteritis nodosa related to hepatitis B virus. A prospective study with long-term observation of 41 patients. Medicine (Baltimore) 1995; 74:238–253
Guillevin L, Lhote F, Gayraud M, Cohen P, Jarrousse B, Lortholary O, Thibult N, Casassus P. Prognostic factors in polyarteritis nodosa and Churg-Strauss syndrome. A prospective study in 342 patients. Medicine (Baltimore) 1996; 75:17–28
Goldberg JW. Primary angiitis of the central nervous system. In: Rolak LA, Harati Y (eds) Neuroimmunology for the Clinician. Butterworth-Heinemann 1997, Boston, pp 177–186
Goodwin J. Temporal arteriitis. In: Gilman S (editor in chief ) Neurobase, 4th 2000 ed. Ann Arbor Publishing 2000
Guillevin L, Lhote F, Sauvaget F, Deblois P, Rossi F, Levallois D, et al. Treatment of polyarteritis nodosa related to hepatitis B virus with interferon-alpha and plasma exchanges. Ann Rheum Dis 1994; 53:334–337
Haubitz M, Schellong S, Gobel U, Schurek HJ, Schaumann D, Koch KM, et al. Intravenous pulse administration of cyclophosphamide versus daily oral treatment in patients with antineutrophil cytoplasmic antibody-associated vasculitis and renal involvement: a prospective, randomized study. Arthritis Rheum 1998; 41:1835–1844
Hoffman GS, Cid MC, Rendt-Zagar KE, Merkel PA, Weyand CM, Stone JH, Salvarani C, Xu W, Visvanathan S, Rahman MU (Infliximab-GCA Study Group). Ann Intern Med 2007; 146:621–630
Holle JU, Gross WL. Neurological involvement in Wegener’s granulomatosis. Curr Opin Rheumatol 2011; 23:7–11
Irani DN. Neurologic complications of the hepatitis virus. In: Gilman S (editor in chief ) Neurobase, 4th ed. Ann Arbor Publishing 2000
Kidd D, Steuer A, Denman AM, Rudge P. Neurological complications in Behcet’s syndrome. Brain 1999; 122:2183–2194
Kraemer M, Berlit P. Primary central nervous system vasculitis: clinical experiences with 21 new European cases. Rheumatol Int 2011; 31:463–472
Langford CA, Talar-Williams C, Barron KS, Sneller MC. A staged approach to the treatment of Wegener’s granulomatosis: induction of remission with glucocorticoids and daily cyclophosphamide switching to methotrexate for remission maintenance. Arthritis Rheum 1999; 42:2666–2673
McRae D, Buchanan G. Long-term sulfamethoxazoletrimethoprim in Wegener’s granulomatosis. Arch Otolaryngol Head Neck Surg 1993; 119:103–105
Moore PM. Diagnosis and management of isolated angiitis of the central nervous system. Neurology 1989; 39:167–173
Moore PM, Richardson B. Neurology of the vasculitides and connective tissue diseases. J Neurol Neurosurg Psychiat 1998; 65:10–22
Murphy JM, Gomez-Anson B, Gillard JH. Wegener Granulomatosis: MR Imaging findings in brain and meninges. Radiology 1999; 213:794–799
Newman GC. CNS Vasculitis. Clinical neuroimmunology, Education Syllabus, AAN 1998, pp 2FC.005-143-2FC.005-174
Nishino H, Rubino FA, DeRemee RA, Swanson JW, Parisi JE. Neurological involvement in Wegener’s granulomatosis: an analysis of 324 consecutive patients at the Mayo Clinic. Ann Neurol 1993; 33:4–9
Pomper MG, Miller TJ, Stone JH. CNS vasculitis in autoimmune disease: MR imaging findings and correlation with angiography. AJNR 1999; 20:75–85
Provenzale JM, Allen NB. Wegener granulomatosis: CT and MR findings. ANJR 1996; 17:785–792
Reinhold-Keller E, De Groot K, Rudert H, Nolle B, Heller M, Gross WL. Response to trimethoprim/sulfamethoxazole in Wegener’s granulomatosis depends on the phase of disease. QJM 1996; 89:15–23
Sakane T, Takeno M, Suzuki N, Inaba G. Behcet’s disease. N Engl J Med 1999; 341:1284–1291
Salvarani C, Brown RD Jr, Calamia KT, Christianson TJ, Weigand SD, Miller DV, Giannini C, Meschia JF, Huston J 3rd, Hunder GG. Primary central nervous system vasculitis: analysis of 101 patients. Ann Neurol 2007; 62:442–451
Schmidley JW. Central nervous system angiitis. Butterworth- Heinemann 2000, Boston
Schmidt WA, Kraft HE, Vorpahl K, Lutz V, Gromnica-Ihle EJ. Color duplex ultrasonography in the diagnosis of temporal arteritis. N Engl J Med 1997; 337:1336–1342
Siva A, Fresko II. Behcet’s Disease. Curr Treat Options Neurol 2000; 2:435–448
Siva A. Vasculitis of the nervous system. J Neurol 2001; 248:451–468
Specks U, Moder KG, McDonald TJ. Meningeal involvement in Wegener granulomatosis. Mayo Clin Proc 2000; 75:856–859
Spiera RF, Mitnick HJ, Kupersmith M, Richmond M, Spiera H, Peterson MG, et al. A prospective, double-blind, randomized, placebo controlled trial of methotrexate in the treatment of giant cell arteritis (GCA). Clin Exp Rheumatol 2001; 19:495–501
Stegeman CA, Cohen Tervaert JW, de Jong PE, Kallenberg CG. Trimethoprim-sulfamethoxazole (co-trimoxazole) for the prevention of relapses of Wegener’s granulomatosis. Dutch Co-Trimoxazole Wegener Study Group. N Engl J Med 1996; 335:16–20
Stone JH, Tun W, Hellman DB. Treatment of non-life threatening Wegener’s granulomatosis with methotrexate and daily prednisone as the initial therapy of choice. J Rheumatol 1999; 26:1134–1139
Talar-Williams C, Hijazi YM, Walther MM, Linehan WM, Hallahan CW, Lubensky I, et al. Cyclophosphamide-induced cystitis and bladder cancer in patients with Wegener granulomatosis. Ann Intern Med 1996; 124:477–484
Valeriano-Marcet J, Spiera H. Treatment of Wegener’s granulomatosis with sulfamethoxazole-trimethoprim. Arch Intern Med 1991; 151:1649–1652
Wechsler B, Dell’Isola B, Vidailhet M, Dormont D, Piette JC, Bletry O, Godeau P. MRI in 31 patients with Behçet’s disease and neurological involvement. Prospective study with clinical correlation. J. Neurol Neurosurg Psychiat 1993; 56:793–798
Woolfenden AR, Tong DC, Marks MP, et al. (1998) Angiographically defined primary angiitis of the CNS: Is it really benign? Neurology 51:183–188
Yazici H, Yurdakul S, Hamuryudan V. Behcet disease. Curr Opin Rheumatol 2001; 13:18–22
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Schwab, S., Schellinger, P., Werner, C., Unterberg, A., Hacke, W. (2012). Autoimmunerkrankungen. In: Schwab, S., Schellinger, P., Werner, C., Unterberg, A., Hacke, W. (eds) NeuroIntensiv. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-16911-3_33
Download citation
DOI: https://doi.org/10.1007/978-3-642-16911-3_33
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-16910-6
Online ISBN: 978-3-642-16911-3
eBook Packages: Medicine (German Language)