sarcoidosis Flashcards
what type of condition is sarcoidosis
it is a granulomatous inflammatory condition
what are granulomas
nodules of inflammation full of macrophages
spikes in incedence
young adulthood
~60yrs
who is more frequently effected
women
black people
typical patient
20-40yo black woman presenting with dry cough and SOB
most commonly affected organ
lungs
effect on organs: lungs
mediastinal lymphadenopathy
pulmonary fibrosis
pulmonary nodules
effect on organs: systemic symptoms
fever
fatigue
weight loss
effect on organs: liver
liver nodules
cirrhosis
cholestasis
effect on organs: eyes
uveitis
conjunctivitis
optic neuritus
effect on organs: skin
erythema nodosum
lupus pernio
effect on organs: heart
bundle branch block
heart block
myocardial muscle involvement
effect on organs: kidney
kidney stones (hypercalcaemia) nephrocalcinosis interstitial nephritis
effect on organs: CNS
nodules
pituitary involvement
encephalopathy
effect on organs: peipheral nerve palsy
facial nerve palsy
mononeuritis multiplex
effect on organs: bones
arthralgia
arthritis
myopathy
Lofgren’s syndrome triad
erythema nodosum
bilateral hilar lymphadenopathy
polyarthralgia
differential diagnoses
TB lymphoma hypersensitivity pneuonitis HIV toxoplasmosis histoplasmosis
blood test findings
raised serum ACE hypercalcaemia raised serum soluble IL-2 receptor raised CRP raised Ig
imaging findings
hilar lymphadenopathy
pulmonary nodules
gold standard for confirming diagnosis
histology from biopsy
histological finding
non-caseating granulomas with epithelioid cells
management
none - no/mild symptoms
oral steroids (+ bisphosphonates)
or methotrexate or azathioprine
prognosis
60% resolve
can progress with pulmonary fibrosis + hypertension
Indications for corticosteroid treatment for sarcoidosis are
parenchymal lung disease,
uveitis,
hypercalcaemia
neurological or cardiac involvement
