healthcareЗдравоохранение. HealthcareHealthcare1027-7218Republican Scientific and Practical Center for Medical Technologies, Informatization, Management and Health Economics10.65249/1027-7218-2026-2-58-66healthcare-252Research ArticleНЕПРЕРЫВНОЕ ПРОФЕССИОНАЛЬНОЕ РАЗВИТИЕCONTINUOUS PROFESSIONAL DEVELOPMENTСаркоидоз: становление нозологической концепции (исторический обзор)Sarcoidosis: the formation of a nosological concept (historical review)https://orcid.org/0000-0002-0393-3899КоровкинВ. С.KorovkinV.

Коровкин Валентин Сергеевич – д. м. н., профессор кафедры пульмонологии, фтизиатрии, аллергологии и профпатологии с курсом ПКиП

Пр. Дзержинского, 83, 220116, г. Минск

Белорусский государственный медицинский университетBelarus202616032026025866Copyright © Коровкин В.С., 20262026Коровкин В.С.Korovkin V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://healthcare.ejournal.by/jour/article/view/252

В Международной классификации болезней 10-го пересмотра саркоидоз отнесен к классу болезней крови, кроветворных органов и иммунологических нарушений.

Описанное почти 150 лет тому назад заболевание остается загадочным и нередко ставит сложные дифференциально-диагностические задачи перед пульмонологами, урологами, офтальмологами, дерматологами, кардиологами, невропатологами и гинекологами. В представленном обзоре описаны основные этапы изучения этой патологии, разнообразные ее манифестации, подчеркнута важная роль отдельных исследователей в диагностике различных проявлений саркоидоза.

In the International Classification of Diseases, 10th revision, sarcoidosis is classified under the category of diseases of the blood, hematopoietic organs, and immunological disorders.

Described nearly 150 years ago, this disease remains enigmatic and often poses complex differential diagnostic challenges for pulmonologists, urologists, ophthalmologists, dermatologists, cardiologists, neurologists, and gynecologists. This review describes the key stages of studying this pathology, its diverse manifestations, and emphasizes the important role of individual researchers in diagnosing the various manifestations of sarcoidosis.

саркоидозисториядиагностикалечениеsarcoidosishistorydiagnosistreatmentReferencesHutchinson, J. Anomalous diseases of skin and fingers: case of livid papillary psoriasis / J. Hutchinson // Illustrations of clinical surgery. – 1877. – Vol. 1. – P. 42–43.Hutchinson J. Anomalous diseases of skin and fingers: case of livid papillary psoriasis? Illustrations of clinical surgery. 1877; 1: 42–43.Hutchinson, J. Mortimer’s malady : a form of lupus pernio / J. Hutchinson // Archives of Surgery. – 1898. – Vol. 9. – P. 307–315.Hutchinson J. Mortimer’s malady: a form of lupus pernio. Arch Surg. 1898; 9: 307–315.Willan, R. Description and Treatment of Cutaneous Diseases / R. Willan. – London : J. Johnson, 1798.Willan R. Description and Treatment of Cutaneous Diseases. London: J. Johnson; 1798.Besnier, E. Lupus pernio de la face: synovites fongueuses symetriques des extremites superieures / E. Besnier // Annales de dermatologie et de syphiligraphie. – 1889. – Vol. 10. – P. 333–336.Besnier E. Lupus pernio de la face: synovites fongueuses symétriques des extrémités supérieures. Ann Dermatol Syphiligr. 1889; 10: 333–336.Boeck, C. Multiple benign sarcoid of the skin / C. Boeck // Journal of Cutaneous and Genito-Urinary Diseases. – 1899. – Vol. 17. – P. 543–550.Boeck C. Multiple benign sarcoid of the skin. J Cutan Genito-Urin Dis. 1899; 17: 543–550.Саркоидоз : монография / под ред. А. А. Визеля ; Российское респираторное о-во. – М. : Атмосфера, 2010. – 416 с. – (Серия монографий Российского респираторного общества).Vizel' A.A. Sarcoidosis. Moscow: Atmosfera; 2010. 416. (in Russian)Теребинский, В. И. К вопросу о Multiple benigne Sarcoid der Haut (Boeck) (Benignes Mitiar Lupoid) / В. И. Теребинский. – Харьков, 1907.Terebinskij, V. I. On the Question of Multiple Lupoid Sarcoids (Multiple Lupoids). Har'kov; 1907. (in Russian)Schaumann, J. Etude sur le lupus pernio et ses rapports avec les sarcoides et la tuberculose / J. Schaumann // Annales de Dermatologie et de Syphilographie. – 1916–1917. – Vol. 6. – P. 357–373.Schaumann J. Etude sur le lupus pernio et ses rapports avec les sarcoides et la tuberculose. Ann Dermatol Syphiligr. 1916–1917; 6: 357–373.Barber, H. W. Benign lymphogranuloma (Schaumann) / H. W. Barber // Proceedings of the Royal Society of Medicine. – 1927. – Vol. 20(9). – P. 1344‒1345.Barber H.W. Benign lymphogranuloma (Schaumann). Proc R Soc Med. 1927; 20(9): 1344‒1345.Holubar, K. In memory of J. F. F. Theodor Langhans (1839–1915) / K. Holubar // Wiener klinische Wochenschrift. – 1989. – Vol. 101, № 24. – P. 867‒870.Holubar K. In memory of J. F. F. Theodor Langhans (1839–1915). Wien Klin Wochenschr. 1989; 101(24): 867‒870.Holubar, K. Paul Wilhelm Heinrich Langerhans (1847–1888). In memory of the centenary of his death 20 July 1988 / K. Holubar // Wiener Klinische Wochenschrift. – 1988. – Vol. 100, № 15. – P. 514‒519.Holubar K. Paul Wilhelm Heinrich Langerhans (1847–1888). In memory of the centenary of his death 20 July 1988. Wien Klin Wochenschr. 1988; 100(15): 514‒519.Jungling, O. Ostitis tuberculosa multiplex cystica (eine eigenartige Form der Knochentuberkulose) / O. Jungling // Fortschritte auf dem Gebiete der Rontgenstrahlen. – Hamburg, 1919–1921. – Vol. 27. – P. 375–383.Jungling O. Ostitis tuberculosa multiplex cystica (eine eigenartige Form der Knochentuberkulose). Fortschr Röntgenstr. Hamburg. 1919–1921; 27: 375–383.Perthes, G. C. Munchener medizinische Wochenschrift / G. C. Perthes. – 1922. – Vol. 69 – P. 99.Perthes G.C. Munchener medizinische Wochenschrift. 1922; 69: 99.Heerford, C. F. Uber eine “Febris uveo-parotidea subchronicaˮ, an der Glandula parotis und der Uvea des Augeslokalisiert und haufig mit Paresen cerebrospinaler Nerven kompliziert / C. F. Heerford // Graefes Arhiv fur Ophthalmologie. – 1909. – Vol. 70. – P. 254–273.Heerford C.F. Uber eine “Febris uveo-parotidea subchronicaˮ, an der Glandula parotis und der Uvea des Augeslokalisiert und haufig mit Paresen cerebrospinaler Nerven kompliziert. Graefes Arhiv fur Ophthalmologie. 1909; 70: 254–273.Lofgren, S. Etiology and pathogenesis of erythema nodosum and erythema induratum // Nordisk medicin. – 1951. – Vol. 46 (28). – P. 1069‒1072.Lofgren S. Etiology and pathogenesis of erythema nodosum and erythema induratum. Nord Med. 1951; 46(28): 1069‒1072.Lofgren, S. Primary pulmonary sarcoidosis. I. Early signs and symptoms / S. Lofgren // Acta Medica Scandinavica. – 1953. – Vol. 145, № 6. – P. 424‒431.Lofgren S. Primary pulmonary sarcoidosis. I. Early signs and symptoms. Acta Med Scand. 1953; 145(6): 424‒431.Coste, F. Febrile polyarthralgia, first manifestations of Besnier-Boeck-Schaumann sarcoidosis / F. Coste, J. Chabot // Revue du rhumatisme et des maladies osteo-articulaires. – 1953. – Vol. 20, № 2. – P. 154‒157.Coste F., Chabot J. Febrile polyarthralgia, first manifestations of Besnier-Boeck-Schaumann sarcoidosis. Rev Rhum Mal Osteoartic. 1953; 20(2): 154‒157.Harrel, G. Blood chemical changes in Boeck’s sarcoid with particular reference to protein, calcium andphosphatase values / G. Harrel, S. Fisher // Journal of Clinical Investigation. – 1939. – Vol. 18, № 6. – P. 687–693.Harrel G., Fisher S. Blood chemical changes in Boeck’s sarcoid with particular reference to protein, calcium andphosphatase values. J Clin Invest. 1939; 18(6): 687–693.Kveim, M. A. A new and specific cutaneous reaction in Boeck’s sarcoidosis / M. A. Kveim. – Nordisk Medicin, 1941. – P. 169.Kveim M.A. A new and specific cutaneous reaction in Boeck’s sarcoidosis. Nord Med. 1941; 169.Central nervous manifestations of the Besnier-BoeckSchaumann disease / A. F. Essellier, B. J. Koszewski, F. Luthy, H. U. Zollinger // Schweizerische Medizinische Wochenschrift. – 1951. – Vol. 81, № 16. – P. 376‒382.Essellier A.F, Koszewski B.J., Luthy F., Zollinger H.U. Central nervous manifestations of the Besnier-BoeckSchaumann disease. Schweiz Med Wochenschr. 1951; 81(16): 376‒382.Dupont, A. Cutaneous reactions in benign lymphogranulomatosis (Besnier-Boeck-Schaumann disease) / Dupont, A. // Archives belges de dermatologie et de syphiligraphie. – 1951. – Vol. 7, № 2. – P. 104‒108.Dupont A. Cutaneous reactions in benign lymphogranulomatosis (Besnier-Boeck-Schaumann disease). Arch Belg Dermatol Syphiligr. 1951; 7(2): 104‒108.Pautrier, L.M. Diagnostic radiologique des lesions pulmonaires de la maladie de Besnier-Boeck-Schaumann / L. M. Pautrier // Journal de radiologie, d'electrologie & archives d'electricite medicale. – 1947. – Vol. 28, № 11–12. – P. 473–475.Pautrier L.M. Diagnostic radiologique des lesions pulmonaires de la maladie de Besnier-Boeck-Schaumann. J Radiol Electrol Arch Electr Medicale. 1947; 28(11–12): 473–475.Robert, P. Besnier-Boeck-Schaumann disease (disseminated, nodose form degenerating with ulcerations on the lower extremities; involutive, histologic modifications: hyaline sclerosis, necrobiosis, xanthomatosis, calcification) / P. Robert // Dermatologica. – 1950. – Vol. 1, № 4–5. – P. 259‒263.Robert P. Besnier-Boeck-Schaumann disease (disseminated, nodose form degenerating with ulcerations on the lower extremities; involutive, histologic modifications: hyaline sclerosis, necrobiosis, xanthomatosis, calcification). Dermatologica. 1950; 1(4–5): 259‒263.Bronchoscopic and bronchobioptic diagnosis of pulmonary forms of sarcoidosis of Besnier-Boeck-Schaumann / J. Turiaf, P. Marland, Y. Rose, C. Sors // Bulletins et memoires de la Societe medicale des hopitaux de Paris. ‒ 1952. ‒ Vol. 68, № 30–31. – P. 1098‒1115.Turiaf J., Marland P., Rose Y., Sors C. Bronchoscopic and bronchobioptic diagnosis of pulmonary forms of sarcoidosis of BesnierBoeck-Schaumann. Bull Mem Soc Med Hop Paris. 1952; 68(30–31): 1098‒1115.Peer, H. Symptomatology and course of a case of Boeck-Besnier-Schaumann disease / H. Peer, H. Kwerch // Klinische Medizin: Österreichische Zeitschrift für wissenschaftliche und praktische Medizin. – 1952. – Vol. 7, № 1. ‒ Р. 34‒38.Peer H., Kwerch H. Symptomatology and course of a case of Boeck-Besnier-Schaumann disease. Klin Med Osterr Z Wiss Prakt Med. 1952; 7(1): 34‒38.Scadding J. G. Sarcoidosis / J. G. Scadding, D. N. Mitchell. – New York : Springer, 2013. – 704 р.Scadding J.G., Mitchell D.N. Sarcoidosis. New York: Springer; 2013. 704.Paesi, A. M. A case of a special form of extensive lymph node tuberculosis with miliary dissemination simulating Besnier-BoeckSchaumann disease / A. M. Paesi, C. Groppi // L'Ospedale Maggiore. ‒ 1953. ‒ Vol. 41, № 3. ‒ P. 134‒137.Paesi A.M., Groppi C. A case of a special form of extensive lymph node tuberculosis with miliary dissemination simulating Besnier-Boeck-Schaumann disease. Osp Maggiore. 1953; 41(3): 134‒137.Verstraeten, J. M. Respiration function tests in pulmonary sarcoidosis or Besnier-Boeck-Schaumann disease / J. M. Verstraeten, E. A. Gaensler // Journal français de medecine et chirurgie thoraciques. – 1954. – Vol. 8, № 1. – P. 53‒56.Verstraeten J.M., Gaensler E.A. Respiration function tests in pulmonary sarcoidosis or Besnier-Boeck-Schaumann disease. J Fr Med Chir Thorac. 1954; 8(1): 53‒56.Glander, R. Besnier-Boeck-Schaumann disease in children / R. Glander // Monatsschrift fur Kinderheilkunde. – 1954. – Vol. 102, № 5. – P. 267‒274.Glander R. Besnier-Boeck-Schaumann disease in children. Monatsschr Kinderheilkd. 1954; 102(5): 267‒274.Longocope, W. T. A study of sarcoidosis; based on a combined investigation of 160 cases including 30 autopsies from The Johns Hopkins Hospital and Massachusetts General Hospital / W. T. Longocope, D. G. Freiman // Medicine (Baltimore). – 1952. – Vol. 31, № 1. – P. 1–132.Longocope W.T., Freiman D.G. A study of sarcoidosis; based on a combined investigation of 160 cases including 30 autopsies from The Johns Hopkins Hospital and Massachusetts General Hospital. Medicine (Baltimore). 1952; 31(1): 1–132.James D. R., Williams J. Sarcoidosis and other granulomatous disorders. Philadelphia : Saunders. – 1985. – Vol. 1. – P. 508.James D.R., Williams J. Sarcoidosis and other granulomatous disorders. Philadelphia: Saunders. 1985; 1: 508.Wurm, K. Der lungenboek im rontgenbild / K. Wurm, H. Reindell, L. Heilmeyer. – Stuttgart : Georg Thieme. – 1958. – 219 p.Wurm K., Reindell H., Heilmeyer L. Der lungenboek im rontgenbild. Stuttgart: Georg Thieme; 1958. 219.Transbronchial lung biopsy for diagnosing sarcoidosis / S. K. Koerner, A. J. Sakowitz, R. I. Appelman [et al.] // The New England journal of medicine. – 1975. – Vol. 293. – P. 268–270.Koerner S.K., Sakowitz A.J., Appelman R.I., et al. Transbronchial lung biopsy for diagnosing sarcoidosis. N Engl J Med. 1975; 293: 268–270.Lieberman, J. The specificity and nature of serum-angiotensin-converting enzyme (serum ACE) elevations in sarcoidosis / Annals of the New York Academy of Sciences. – 1976. – Vol. 278. – P. 488–497.Lieberman J. The specificity and nature of serum-angiotensin-converting enzyme (serum ACE) elevations in sarcoidosis. J Ann N Y Acad Sci. 1976; 278: 488–497.Hunninghake G. W. Bronchoalveolar T lymphocytes and pulmonary sarcoidosis / G. W. Hunninghake, R. G. Crystal // American Review of Respiratory Disease. – 1981. – Vol. 123. – P. 407–412.Hunninghake G.W., Crystal R.G. Bronchoalveolar T lymphocytes and pulmonary sarcoidosis. Am Rev Respir Dis. 1981; 123: 407–412.Isolation and structural identiication of 1,25-dihydroxyvitamin D3 produced by cultured alveolar macrophages in sarcoidosis / J. S. Adams, F. R. Singer, M. A. Gacad [et al.] // The Journal of Clinical Endocrinology & Metabolism. – 1985. – Vol. 60, № 5. – P. 960–966.Adams J.S., Singer F.R., Gacad M.A., et al. Isolation and structural identiication of 1,25-dihydroxyvitamin D3 produced by cultured alveolar macrophages in sarcoidosis. J Clin Endocrinol Metab. 1985; 60(5): 960–966.Supplement devoted to the 1st WASOG meeting. Estoril, Lisbon Coast, October 22th–24th, 1989 // Sarcoidosis. – 1989. – Vol. 6. – P. 1–128.Supplement devoted to the 1st WASOG meeting. Sarcoidosis. 1989; 6: 1–128.ATS/ERS/WASOG statement on sarcoidosis. American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and other Granulomatous Disorders / G. W. Hunninghake, U. Costabel, M. Ando [et al.] // Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG. – 1999. – Vol. 16, № 2. ‒ P. 149‒173.Hunninghake G.W., Costabel U., Ando M., et al. ATS/ERS/WASOG statement on sarcoidosis. American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and other Granulomatous Disorders. Sarcoidosis Vasc Diffuse Lung Dis. 1999; 16(2): 149‒173.Илькович, М. М. Саркоидоз органов дыхания : руководство для врачей / М. М. Илькович, Л. Н. Новикова, В. С. Лучкевич. – СПб., 1996.Il'kovich M.M,. Novikova L.N., Luchkevich V.S. Sarcoidosis of the respiratory system. Spb.; 1996. (in Russian)Самцов, А. В. Саркоидоз / А. В. Самцов, М. М. Илькович, Н. С. Потекаев. – СПб. : Невский диалект, 2001.Samcov A.V., Il'kovich M.M., Potekaev N.S. Sarcoidosis. Spb.: Nevskij dialect; 2001. (in Russian)Каминская, Г. О. Представления о метаболических сдвигах, сопутствующих саркоидозу / Г. О. Каминская // Проблемы туберкулеза. – 2006. – № 3. – С. 52–61.Kaminskaya G.O. Concepts of metabolic changes associated with sarcoidosis. Problemy tuberkuleza. 2006; 3: 52–61. (in Russian)Диагностика и лечение саркоидоза : резюме Федеральных согласительных клинических рекомендаций (Часть II. Диагностика, лечение, прогноз) / А. Г. Чучалин, А. А. Визель, М. М. Илькович [и др.] // Вестник современной клинической медицины. – 2014. – Т. 7, вып. 5. – С. 73–81.Chuchalin A.G., Vizel', A.A. Il'kovich M.M., et al. Diagnosis and Treatment of Sarcoidosis. Vestnik sovremennoj klinicheskoj mediciny. 2014; 7(5): 73–81. (in Russian)Judson, M. A. The etiologic agent of sarcoidosis. What if there isn’t one? / M. A. Judson // Chest. – 2003. – Vol. 124. – P. 6–8.Judson M.A. The etiologic agent of sarcoidosis. What if there isn’t one? Chest. 2003; 124: 6–8.Spagnolo, P. Recent advances in the genetics of sarcoidosis / P. Spagnolo, J. Grunewald // Journal of Medical Genetics. – 2013. – Vol. 50. – P. 290–297.Spagnolo P., Grunewald J. Recent advances in the genetics of sarcoidosis. J Med Genet. 2013. 50: 290–297.Spagnolo, P. Environmental triggers and susceptibility factors in idiopathic granulomatous diseases / P. Spagnolo, L. Richeldi, R. M. du Bois // Seminars in respiratory and critical care medicine. – 2008 – Vol. 29. – P. 610–619.Spagnolo P., Richeldi L., du Bois R. M. Environmental triggers and susceptibility factors in idiopathic granulomatous diseases. Semin Respir Crit Care Med. 2008; 29: 610–619.Noor, A. Immunopathogenesis of sarcoidosis / A. Noor, K. S. Knox Clinics in dermatology. – 2007. – Vol. 25. – P. 250–258.Noor A., Knox K.S. Immunopathogenesis of sarcoidosis. Clin Dermatol. 2007; 25: 250–258.Zissel, G. Cellular activation in the immune response of sarcoidosis / G. Zissel // Seminars in Respiratory and Critical Care Medicine. – 2014. – Vol. 35. – P. 307–315.Zissel G. Cellular activation in the immune response of sarcoidosis. Semin Respir Crit Care Med. 2014; 35: 307–315.Grunewald, J. Lofgren’s syndrome. Human Leukocyte Antigen strongly influences the disease course / J. Grunewald, A. Eklund // American Journal of Respiratory and Critical Care Medicine. – 2009. – Vol. 179. – P. 307–312.Grunewald J., Eklund A. Lofgren’s syndrome. Human Leukocyte Antigen strongly influences the disease course. Am J Respir Crit Care Med. 2009; 179: 307–312.Iannuzzi, M. C. Sarcoidosis: clinical presentation, immunopathogenesis, and therapeutics / M. C. Iannuzzi, J. R. Fontana // JAMA. – 2011. – 305, № 4. – P. 391–399.Iannuzzi M.C., Fontana J.R. Sarcoidosis: clinical presentation, immunopathogenesis, and therapeutics. JAMA. 2011; 305(4): 391–399.Балионис, О. И. Генетические предикторы течения саркоидоза легких в российской популяции / О. И. Балионис, А. Г. Никитин, А. В. Аверьянов // Вестник современной клинической медицины. – 2022. – Т. 15, вып. 4. – С. 18–25.Balionis O.I., Nikitin A.G., Aver'yanov A.V. Genetic predictors of the course of pulmonary sarcoidosis in the Russian population. Vestnik sovremennoj klinicheskoj mediciny. 2022; 15(4): 18–25. (in Russian)Саркоидоз : федеральные клинические рекомендации по диагностике и лечению / А. Г. Чучалин, С. Н. Авдеев, З. Р. Айсанов [и др.]. // Пульмонология. – 2022. – Т. 32, № 6. – C. 806–833.Chuchalin A. G., Avdeev S. N., Ajsanov Z. R. Sarcoidosis. Pul'monologiya. 2022; 32(6): 806–833. (in Russian)

The authors declare that there are no conflicts of interest present.