Sarcoidosis Flashcards
What is sarcoidosis?
Multisystem disease of unknown aetiology characterised by the presence of non-caseating granulomas (unlike TB) in tissues and organs.
What is a granuloma?
An aggregation of activated macrophages.
What organs does sarcoidosis affect?
- Lymph nodes
- Lungs
- Skin
- Eyes
- Lacrimal and salivary gland
- Nervous system
How does sarcoidosis affect the lymph nodes?
- Virtually all cases of sarcoidosis involves lymph nodes.
- Hilar and mediastinal lymphadenopathy
- Picked up on CXR
How does sarcoidosis affect the lungs?
- Lungs frequently involved
- Lung fibrosis from healing of granulomas
- Cor pulmonale and respiratory failure if severe
How does sarcoidosis affect the skin?
- Lupus pernio - maculopapular rash on face and trunk
2. Erythema nodosum associated with sarcoidosis
How does sarcoidosis affect the eyes?
Uveitis - inflammation of uveal tract:
- Anterior - red, painful eye with photophobia, self-limiting.
- Posterior - floaters, blurred vision, chronic form of disease.
How does sarcoidosis affect the lacrimal and salivary glands?
Dry eyes and mouth
How does sarcoidosis affect the nervous system?
- CN VII palsy common
2. Hypothalamic involvement common - causing diabetes insipidus due to destruction of ADH producing neurons.
What is this describing and what is the prognosis?
Associated with manifestations that include bilateral hilar lymphadenopathy, anterior uveitis and CN VII palsy.
- Acute sarcoidosis (most patients with sarcoidosis)
2. Good prognosis, spontaneous resolution within 1-2 years of diagnosis, no chronic consequences.
What is this describing and what is the prognosis?
Associated with lupus pernio, pulmonary fibrosis and posterior uveitis.
- Chronic sarcoidosis (5% of patients with sarcoidosis)
2. Tends to persist and lead to permanent organ damage.
What are the findings in blood tests of sarcoidosis?
- ESR raised
- Hypercalcaemia present in 10% (granulomas convert vit D to active form)
- Raised serum ACE (granulomas produce)
How is sarcoidosis effectively diagnosed?
Biopsy in less clear-cut cases, otherwise clinical and simple tests ruling out other conditions.