Rheumatology- other autoimmune (sjogern, scleroderma ect.)

Question 1

Signs and symptoms of sarcoidosis

Answer 1

Cough dyspnea & chest pain 
Skin lesions (erythema nodosum) 
Anterior/ posterior uveitis 
Lofgren syndrome
Parotid gland swelling

Question 2

Diagnosis: multiple tender pink to reddish nodules below the knee

Answer 2

Erythema Nodosum. Painful subcutaneous nodules that most common on the anterior lower legs

Question 3

Diseases associated with erythema nodosum

Answer 3

Typically a delayed hypersensitivity reaction acossiated with:
Strep infections,
Sarcoidosis (28% of EN pts have sarcoidosis)
TB,
Endemic fungal disease (histoplasmosis),
IBD,
Behçet disease.

Question 4

Initial work up for erythema nodosum

Answer 4

Basic Lab tests (CBC, LFT, renal function)
Antistreptolysin-O antibodies
TB testing
Chest X ray (access for sarcoidosis, TB)

Question 5

Diagnosis of sarcoidosis

Answer 5

Labs:
Hypercalcenia/ Hypercalciuria
Elevated ACE level

Imaging:
Bilateral hilar adenopathy
Pulmonary reticular infiltrates
(50% cases diagnosed without pulmonary symptoms with incidental CXR findings)

Question 6

Erythema nodosum work up: antinuclear antibodies

Answer 6

ANA have high sensitivity for SLE and can be useful in rolling it out. However, SLE is not common causal of erythema nodosum

Question 7

Anticitrullinated peptide antibodies

Answer 7

Rheumatoid arthritis