Sarcoidosis

Question 1

what is sarcoid?

Answer 1

multi-system disorder characterised by accumulation of lymphocytes and macrophages and the formation of non-caseating granulomas in the lungs and other organs

Question 2

presentation?

Answer 2

bimodal age distribution with 2 peaks in the third and fifth decades

Dry cough
Fatigue
Arthalgia - Pain in knees, ankles, and wrists.

Lungs;
Wheeze
Lymphadenopathy - Cervical, submandibular

Eyes; Uveitis- Blurred vision, red eye, Photophobia

Skin; eryhtema nodosum, lupus pernio

Question 3

IVX OF SARCOID?

Answer 3

Imaging;
1. CXRAY

bloods;

1. Serum ACE
2. FBC; leukopaenia, anaemia - if BMarow involved
3. UEs - hypercalcaemia (+calciuria)

Flexible bronchoscopy + lung biopsy

Question 4

XRAY findings on sarcoid?

Answer 4

Stage I: bilateral hilar lymphadenopathy

Stage II: bilateral hilar lymphadenopathy plus pulmonary infiltrates

Stage III: pulmonary infiltrates without hilar lymphadenopathy

Stage IV: extensive fibrosis with distortion.

Question 5

rx sarcoid?

Answer 5

Observation

Symptomatic stage I with progressive adenopathy or stage 2+;
1. Oral prednisolone or inhaled budesonide

2. May give methotrexate, azathioprine
3. O2, lung transplant

Skin and eyes;
topical steroids

Question 6

prognosis?

Answer 6

the earlier your stage the better you prognosis. no chance of remission at stage 4