Fall 2014: Week 10: Sarcoidosis

Question 1

What is Sarcoidosis?

Answer 1

1. Multisystem granulomatous disorder of unknown etiology

Question 2

Epidemiology

1. Amt per 100,000 population?
2. More common in what race?
3. Males or females?
4. Onset?
5. Acute or chronic Dz?
6. Affects what the most?

Answer 2

1. 10-20
2. AA
3. Females
4. 20-50 yrs old
5. either
6. Lungs, then Lymph Nodes, then Eyes

Question 3

Ocular Involvement

1. Type of Uveitis?
2. Infiltrates found where?
3. Retinal involvement?
4. ON Involvement?
5. What else?

Answer 3

1. Granulomatous
2. Choroid (granuloma)..
3. Yes. Retinal Periphlebitis
4. Yes
5. DRY EYE

Question 4

Pulmonary Involvement

1. Most common systemic Manifestation
   a. Classified into how many stages?

b. U/L or B/L?
2. Symptoms?

Answer 4

1. a. 4 stages
   b. B/L Hilar Lymphadenopathy
2. Cough, Shortness of breath, Wheezing, Chest pain

Question 5

Dermatologic Lesions

1. What 3?

Answer 5

1. Erythema Nodosum
2. Lupus Pernio
3. Papules

Question 6

Bones, Joints

1. What can happen?

Answer 6

Migratory Polyarthritis

Painful red inflamed joints

Bone Cysts, Lattice-Like Lesions

Painful Swelling

Question 7

Neurosarcoidosis

1. Complications in what % of Pts w/Sarcoidosis?
2. Most COMMON CN PALSY?
3. Space occupying granulomatous lesion in CNS
   a. INCREASED ICP
   b. Post-Chiasmal
   c. At Chiasm

Answer 7

1. ~5%

Any portion of Central or PNS can be affected

• Can get U/L or B/L Disc Swelling and Disc Pallor
  2. FACIAL NERVE PALSY
  3. a. Papillema, HAs
  b. Homonymous Hemianopsia
  c. Bitemporal for junctional VF Defect
• Others: Peripheral neuropathy; Meningitis; Neuroendocrine Dysfunction; Hydrocephalus

Question 8

Diagnostic Testing

1. Big thing to do?

2.

Answer 8

1. Chest X-ray or CT
   * Tissue Bx (evidence of non-caseating granulomas)

Imaging: Gallium Scans

ACE *increased in 75%!!! or SERUM LYSOZYME

Question 9

Tx?

Answer 9

Corticosteroids

Immunosuppressants

Observation

Prognosis: VARIES
a. Can resolve over 1-2 years. Relapsing remitting course
Progressive Dz

Question 10

Review

1. Cause?
2. Multisystem: Most Common?
3. Consider in what eye issue?
4. Watch for what?
5. Tx?

Answer 10

1. Idiopathic Granulomatous Dz
2. Lungs
3. Granulomatous Uveitis
4. Neurological signs and symptoms
5. Corticosteroids
   * Diagnostic Testing