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| ==Medical Therapy== | | ==Medical Therapy== |
| [[Corticosteroid]]s, most commonly [[prednisone]], have been the standard treatment for many years. In some patients, this treatment can slow or reverse the course of the disease, but other patients unfortunately do not respond to steroid therapy. The use of corticosteroids in mild disease is controversial because in many cases the disease remits spontaneously. Additionally, corticosteroids have many recognized dose- and duration-related side effects (which can be reduced through the use of alternate-day dosing for those on chronic prednisone therapy <ref>[http://www.uspharmacist.com/NewLook/CE/glucocort/lesson.htm "Dosing Considerations"]</ref>), and their use is generally limited to severe, progressive, or organ-threatening disease. The influence of corticosteroids or other [[immunosuppressant]]s on the natural history is unclear.
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| Severe symptoms are generally treated with steroids, and [[steroid-sparing agent]]s such as [[azathioprine]] and [[methotrexate]] are often used. Rarely, [[cyclophosphamide]] has also been used. As the granulomas are caused by collections of immune system cells, particularly [[T cell]]s, there has been some early indications of success using immunosuppressants, [[interleukin-2]] inhibitors or anti-[[tumor necrosis factor-alpha]] treatment (such as [[infliximab]]). Unfortunately, none of these have provided reliable treatment and there can be significant side effects such as an increased risk of reactivating latent [[tuberculosis]].
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| Avoidance of sunlight and Vitamin D foods may be helpful in patients who are susceptible to developing [[hypercalcemia]].
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| ==References== | | ==References== |