Sarcoidosis Flashcards
What is sarcoidosis?
Multi-system disease characterised by granuloma formation, resulting in widespread inflammatory changes and complications.
What is sarcoidosis characterisd by?
Granuloma formation resulting in widespread inflammation
In who is sarcoidosis more common in?
Young adults and in people of African descent
What can the features of sarcoidosis be divided into?
Acute and Chronic
What are the acute features of sarcoidosis?
Fever
Polyarthralgia
Erythema nodosum
Bilateral hilar lymphadenopath
What syndrome encapsultes the acute features of sarcoidosis?
Löfgren syndrome
What type of prognosis does Löfgren syndrome have?
V good prognosis
What are the more insidious features of sarcoidosis?
Dyspnoea
Non-productive cough
Malaise
Weight loss
What skin changes might occur in someone with sarcoidosis?
Erythema nodosum
Lupus pernio.
What metabolic disturbance can occur in someone with sarcoidosis?
Hypercalcaemia
How does hypercalcaemia occur in someone with sarcoidosis?
Macrophages inside the granulomas cause an increased conversion of vitamin D to its active form (1,25-dihydroxycholecalciferol)
What syndrome can occur secondary to sarcoidosis?
Heerfordt’s syndrome
What is Heerfordt’s syndrome?
Parotid enlargement
Fever
Uveitis secondary to sarcoidosis
How is sarcoidosis usually diagnosed?
Tissue biopsy
What would a tissue biopsy of someone with sarcoidosis show?
Non-caseating granulomas
What else can be used in the diagnosis of sarcoidosis?
Bloods
Chest x-ray or CT
What might you find in the bloods of someone with sarcoidosis?
Raised ESR, ACE and calcium
Reduced lymphocytes.
What would you see on a stage 1 chest x-ray of someone with sarcoidosis?
Bilateral Hilar lymphadenopathy
What would you see on a stage 2 chest x-ray of someone with sarcoidosis?
BHL + interstitial infiltrates
What would you see on a stage 3 chest x-ray of someone with sarcoidosis?
Diffuse interstitial infiltrates only
What would you see on a stage 4 chest x-ray of someone with sarcoidosis?
Diffuse fibrosis
What would you find on spirometry of someone with sarcoidosis?
Restrictive pattern
What is the management of sarcoidosis?
Steroids
What are possible indications for steroid therapy?
Patients with chest x-ray stage 2 or 3 disease who are symptomatic
Hypercalcaemia
Eye, heart or neuro involvement
What factors might indicate a poor prognosis in someone with sarcoidosis?
Insidious onset
Symptoms > 6 months
absence of erythema nodosum
extrapulmonary manifestations: e.g. lupus pernio, splenomegaly
CXR: stage III-IV features
black people
