| On the nature of sarcoidosis. | |
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MedLine Citation:
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PMID: 22284237 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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More than 140years since its recognition as a clinical entity, sarcoidosis remains enigmatic. Its classification as a disease vs. a syndrome is uncertain. Its etiology remains undefined. The "immune paradox" (delayed type hypersensitivity anergy in a setting of exuberant systemic granulomatous response) resists explanation. Its relationship to the Kveim test is poorly understood. Its prognostic determinants and treatment indications are among the unsolved or disputed problems. Immunological investigations generated the thesis that the characterizing systemic granuloma arise as a fallback reaction to inefficient cellular immune processing, due most often to impaired myeloid dendritic cell function of unknown cause. The concept that sarcoidosis represents a (genetically conditioned) default to a more primitive immunological response provides a unifying explanation for its development in persons with a variety of antigenic exposures and in individuals with cellular immune deficiencies. It furnishes a coherent explanation for the apparent paradox that individuals exhibiting the most intense cellular response experience the most favorable outcomes and for the adverse effect of corticosteroid-suppression in recent onset sarcoidosis. |
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Authors:
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Jerome M Reich |
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Publication Detail:
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Type: Journal Article Date: 2011-10-12 |
Journal Detail:
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Title: European journal of internal medicine Volume: 23 ISSN: 1879-0828 ISO Abbreviation: Eur. J. Intern. Med. Publication Date: 2012 Mar |
Date Detail:
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Created Date: 2012-01-30 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9003220 Medline TA: Eur J Intern Med Country: Netherlands |
Other Details:
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Languages: eng Pagination: 105-9 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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