Restrictive Part 2: Granulomatous Diseases Flashcards
What are the two granulomatous diseases she wants us to know?
Sarcoidosis and hypersensensitivity pneumonia
How do we characterize sarcoidosis?
Systemic disease that is manifested by non caseating, non necrotizing granulomas of unknown cause.
What are the 5 most frequently affected areas of the body even though it can be anyplace, what age is most commonly affected, what race, and what gender?
Lungs, Lympnodes (hilar and mediastinal), spleen, eyes and skin.
Older than 40.
AA
Females.
Explain the 4 stages of sarcoidosis based on chest x ray?
Stage 1: no abnormalities
Stage 2: LAD
Stage 3: LAD plus pulmonary infiltration
Stage 4: Fibrosis
What do they think is likely the etiology of sarcoidosis and why?
Immune related because of all the T cells and T cell derived cytokines like IL2 and IFN gamma.
What is the histo hallmark of sarcoidosis?
NON necrotizing granulomas with giant cells. Giant cells have Schaumann bodies (calcium) and stellate inclusions known as asteroid bodies.
What are two symptoms the patient presents with and what two things are elevated in the blood?
Cough or dyspnea.
Hypercalcemia and elevated ACE.
What is going on with hypersensitivity pneumonitis?
Airway centered granulomatous reaction to inhaled organic antigens.
What are the three most common hypersensitivity reactions?
Pigeon breeders lung which is protein from bird poop.
Farmers lung which is from actinomycetes spores that are in hay
Humidifier lung which is from MAC
What is required for diagnosis with hypersensitivity pneumonitis?
A history!
What are three clinical symptoms patient presents with when they have HP?
Fever, cough and dyspnea
