Sarcoidosis

Question 1

what is sarcoidosis

Answer 1

multi-system disease characterised by granuloma formation, resulting in widespread inflammatory changes and complications

Question 2

what parts of the body does sarcoidosis affect

Answer 2

most commonly the lungs and lymph nodes.

But it can also affect the eyes, skin, heart and other organs

Question 3

aetiology of sarcoidosis

Answer 3

unknown aetiology

bacteria, viruses, or chemicals might trigger the disease. It may also be genetic

Question 4

presenting symptoms of sarcoidosis

Answer 4

cough, dyspnoea, chronic fatigue, arthralgia, haemoptysis, weight loss

Question 5

what is lofgren syndrome

Answer 5

acute sarcoidosis

fever, polyarthralgia, erythema nodosum, bilateral hilar lymphadenopathy

Question 6

chronic sarcoidosis features

Answer 6

Pulmonary (most common manifestation): dry cough, dyspnoea, reduced exercise tolerance. Examination may reveal crepitations.

Constitutional: fatigue, weight loss, arthralgia, and low-grade fever. General signs include lymphadenopathy and enlarged parotid glands.

Neurological: meningitis, peripheral neuropathy, bilateral Bell’s palsy.

Ocular: uveitis, keratoconjunctivitis sicca.

Cardiac: arrhythmias, restrictive cardiomyopathy.

Abdominal: hepatomegaly, splenomegaly, renal stones.

Dermatological: erythema nodosum, lupus pernio.

Question 7

investigations for sarcoidosis

Answer 7

CXR, FBC, calcium, reduced lymphocytes and CT chest

tissue biopsy- non caseating granulomas

Question 8

management of sarcoidosis

Answer 8

Bilateral hilar lymphadenopthy alone - usually self-limiting

Acute sarcoidosis - bed rest, NSAIDs

Steroid treatment: oral or IV, depending on severity of disease

Immunosuppressants: in severe disease