Sarcoidosis

Question 1

Sarcoidosis - What is it?

Answer 1

Sarcoidosis is a rare multi-system inflammatory condition that causes small patches of red and swollen tissue, called granulomas, to develop in the organs of the body. It usually affects the lungs and skin

Question 2

Management of sarcoidosis over time

Answer 2

Pulmonary function tests are useful for monitoring course of disease

Question 3

Persons at risk

Answer 3

20 - 45 years old
Persons of Irish, German, Scandinavian, African American, West Indian descent
May appear earlier in African-Americans

Question 4

Clinical Features

Answer 4

Pulmonary - dyspnea, cough, wheezing, chest pain, sore throat, polyps
Dermatologic - Nodules, papules, plaques
Ocular - Photophobia, tearing, pain, decreased visual acuity, lacrimal enlargement
Rheumoatological - Polyarthropathy, myopathy
Neuro - Headache, hearing loss, parathesia, cranial nerve palsy
Cardiac - syncope, CHF, tamponade
GI - Dysphagia, pain, jaundice
Renal - calculi, kidney damage
Hema - Lymph node enlargement

Question 5

Classic signs of sarcoidosis

Answer 5

Noncaseating granuloma
Increased immune response
Most have pulmonary symptoms that are non-specific similar to TB
Many have rheumatologic symptoms
ocular and skin effects are more rare

Question 6

Diagnosis

Answer 6

No conclusive diagnosis but
1 - bilateral hilar lymphadenopathy
2 - parenchymal interstitial infiltrates

Are highly suggestive

PFT may show restriction

Question 7

Treatment

Answer 7

Refer to pulmonary
NSAIDs or prednisone for joint pain / fever
Corticosteroids for dyspnea / cough
Antimetabolites for failed steroid therapy

Question 8

Complications

Answer 8

Depression and stress
Lung scarring (biggest cause of death is lung scarring)
Skin effects
Eye disease
Cranial neuropathy
Fertility issues
Cardiac an Liver damage
Arthritis and muscle damage

Question 9

Staging

Answer 9

0 - Normal chest film
1 - Bilateral hilar lymphadenopathy
2 - BHL with infiltrates
3 - Infiltrates without BHL
5 - pulmonary fibrosis