Sarcoidosis

Question 1

What kind of disease is sarcoidosis?

Answer 1

Multisystem granulomatous disease of unknown cause

Question 2

In what group of people is sarcoidosis most common in?

Answer 2

African-Caribbean women 20-40 years old

Question 3

1) What organ is most commonly affected by sarcoidosis?
2) Name a feature of sarcoidosis in the lungs

Answer 3

1) Lungs
2) Pulmonary nodules, pulmonary fibrosis, mediastinal lymphadenopathy

Question 4

1) Name a systemic symptom of sarcoidosis
2) Name a feature of sarcoidosis in the liver
3) Name a feature of sarcoidosis in the eye

Answer 4

1) Fever, fatigue, weight loss
2) Liver nodules, cirrhosis, cholestasis
3) Uveitis, conjunctivitis, optic neuritis

Question 5

Name a feature of sarcoidosis in the skin

Answer 5

• Erythema nodosum
• Lupus pernio
• Granulomas develop in scar tissue

Question 6

1) What is erythema nodosum?
2) What is lupus pernio?

Answer 6

1) Tender, red nodules on the shins caused by inflammation of the subcutaneous fat
2) Raised, purple skin lesions commonly on cheeks and nose

Question 7

Name 2 other features of sarcoidosis

Answer 7

Bundle branch block, heart block, kidney stones, nephrocalcinosis, interstitial nephritis, encephalopathy, facial nerve palsy, arthritis, myopathy

Question 8

1) What is Lofgren’s syndrome?
2) What is the triad of Lofgren’s syndrome?

Answer 8

1) Specific presentation of sarcoidosis
2) Erythema nodosum, bilateral hilar lymphadenopathy and polyarthralgia

Question 9

Name 2 markers that may be raised in a blood test of someone with sarcoidosis, and which of these may be used as a screening tool?

Answer 9

• Serum ACE (screening)
• Hypercalcaemia
• Soluble interleukin-2 receptor
• CRP
• Immunoglobulins

Question 10

What is the key finding in a chest x-ray of someone with sarcoidosis?

Answer 10

Hilar lymphadenopathy

Question 11

What is the gold standard for confirming a diagnosis of sarcoidosis?

Answer 11

Histology from a biopsy

Question 12

1) What is the management of sarcoidosis when treatment is needed?
2) What drugs are given alongside this medication, and why?

Answer 12

1) Oral corticosteroids
2) Bisphosphonates - protect against osteoporosis

Question 13

What drugs are second line?

Answer 13

Methotrexate or azathioprine

Question 14

Name a condition sarcoidosis can progress to

Answer 14

• Pulmonary fibrosis
• Pulmonary hypertension