Sarcoid Flashcards
What is sarcoidosis?
A rare multisystem granulomatous disorder of unknown aetiology
What are risk factors for developing sarcoidosis?
- 20-40yrs
- Female
- African-Carribeans
- Family history
How does sarcoidosis manifest in the lungs?
- Interstitial lung disease
- Bilateral hilar lymphadenopathy
How does acute sarcoidosis present?
- Fever
- Erythema nodosum
- Polyarthralgia
How does sarcoidosis usually present?
It doesn’t - patients are usually asymptomatic.
Found incidentally on a CXR.
How does ocular sarcoidosis present?
- Uveitis (iris, ciliary body and choroid)
- Pain, redness, photophobia, floaters, visual loss
- Secondary glaucoma
How does cutaneous sarcoidosis present?
- Papular sarcoidosis - On head and neck
- Erythema nodosum
- Lupus pernio (pathognomonic)
How else can sarcoidosis present?
- Hypercalcaemia
- Renal disease (stones, interstitial nephritis)
- Bone cysts
- Hepatosplenomegaly
- Cardiac - Arrythmia, cardiomyopathy, heart failure
What pattern of spirometry will sarcoidosis show?
- Restrictive due to pulmonary infiltrates and fibrosis
What bedside tests should you do?
- Observations
- Spirometry
- Mantoux test
- ECG - Arrythmias or bundle branch block
What blood tests would you request?
- FBC - lymphopenia
- U+E
- LFT - Raised
- ESR/CRP - raised
- Bone profile - Hypercalcaemia
- Serum ACE - Raised in about 70% and levels show response to treatment. Cannot be used diagnostically.
What imaging can be used to diagnose sarcoidosis?
- CXR
- HRCT
What is needed to absolutely confirm the disease?
- Bronchoalveolar lavage - Increased lymphocytes and neutrophils
- Transbronchial biopsy - Non caseating granuloma
What staging is used in sarcoidosis?
Scadding staging - based upon CXR findings. Shows chance of spontaneous reolution.
When will patients not require active treatment?
If they only have bilateral hilar lymphadenopathy
