Sarcoidosis Flashcards

1
Q

What is sarcoidosis?

A

Multisystem disease of unknown aetiology characterised by the presence of non-caseating granulomas (unlike TB) in tissues and organs.

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2
Q

What is a granuloma?

A

An aggregation of activated macrophages.

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3
Q

What organs does sarcoidosis affect?

A
  1. Lymph nodes
  2. Lungs
  3. Skin
  4. Eyes
  5. Lacrimal and salivary gland
  6. Nervous system
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4
Q

How does sarcoidosis affect the lymph nodes?

A
  1. Virtually all cases of sarcoidosis involves lymph nodes.
  2. Hilar and mediastinal lymphadenopathy
  3. Picked up on CXR
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5
Q

How does sarcoidosis affect the lungs?

A
  1. Lungs frequently involved
  2. Lung fibrosis from healing of granulomas
  3. Cor pulmonale and respiratory failure if severe
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6
Q

How does sarcoidosis affect the skin?

A
  1. Lupus pernio - maculopapular rash on face and trunk

2. Erythema nodosum associated with sarcoidosis

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7
Q

How does sarcoidosis affect the eyes?

A

Uveitis - inflammation of uveal tract:

  1. Anterior - red, painful eye with photophobia, self-limiting.
  2. Posterior - floaters, blurred vision, chronic form of disease.
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8
Q

How does sarcoidosis affect the lacrimal and salivary glands?

A

Dry eyes and mouth

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9
Q

How does sarcoidosis affect the nervous system?

A
  1. CN VII palsy common

2. Hypothalamic involvement common - causing diabetes insipidus due to destruction of ADH producing neurons.

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10
Q

What is this describing and what is the prognosis?

Associated with manifestations that include bilateral hilar lymphadenopathy, anterior uveitis and CN VII palsy.

A
  1. Acute sarcoidosis (most patients with sarcoidosis)

2. Good prognosis, spontaneous resolution within 1-2 years of diagnosis, no chronic consequences.

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11
Q

What is this describing and what is the prognosis?

Associated with lupus pernio, pulmonary fibrosis and posterior uveitis.

A
  1. Chronic sarcoidosis (5% of patients with sarcoidosis)

2. Tends to persist and lead to permanent organ damage.

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12
Q

What are the findings in blood tests of sarcoidosis?

A
  1. ESR raised
  2. Hypercalcaemia present in 10% (granulomas convert vit D to active form)
  3. Raised serum ACE (granulomas produce)
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13
Q

How is sarcoidosis effectively diagnosed?

A

Biopsy in less clear-cut cases, otherwise clinical and simple tests ruling out other conditions.

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