sarcodosis

Question 1

what is sarcoidosis an who does it affect

Answer 1

multisystem granulomatous disorder, characterised by growth of granulomas.

commonly affecting young adults. common in the USA but uncommon in JAPAN, peak incidence is in 3rd and 4th decades, female predominance. and 1st degree relatievs have an increased risk

Question 2

what is the cause of sarcoidosis

Answer 2

• it is unknown
• proposed aetiological factors include the Epstein-barr virus, atypical mycobacterium or fungus, and occupational, genetic, social or other environmental factors.

Question 3

immunopathology of sarcoidosis

Answer 3

• there is a decrease in circulating T lymphocytes and changes in delayed hypersensitivity responses are the result of sequestration of lymphocytes within the lung.

key role in the development of sarcoidosis is played by T cells as they promote cellular immune reaction and are usually associated with an inverted CD4/CD8 ratio. It is well characterized by noncaseating granuloma typically containing macrophages, multinucleated giant cells, and epithelioid cells.

Question 4

sarcoidosis clinical features

Answer 4

• fatigue, swollen lymph nodes, weight loss, pain and swelling in joints for example the ankles
• 4 stages of pulmonary involvement
  stage 1 - bilateral hilar lymphadenopathy (BHL) alone - dull ache in chest, malaise and a mild fever.
  stage 2 - BHL with pulmonary infiltrates
  stage 3 - pulmonary infiltrates with shrinking hilar nodes
  stage 4 - fibrosis with pulmonary infiltrates
• skin lesions, darker or lighter, red rash on shins or ankles
• vision - blurred, pain, burning itching or dry eyes.

Question 5

sarcoidosis risk factors

Answer 5

age and sex - 20 to 60 and women
race - african and nothern european
family history

Question 6

diagnosis and treatment of sarcoidosis

Answer 6

• x-ray or CT scan, lab tests
  treatment
• corticosteroids
• with no improvement there is prednisolone