Sarcoidosis

Question 1

What is sarcoidosis?

Answer 1

Granulomatous inflammatory condition

Granulomas are nodules of inflammation full of macrophages

Question 2

What are some extra pulmonary manifestations ?

Answer 2

Erythema nodosum
Lymphadenopathy

Question 3

What are some symptoms?

Answer 3

Asymptomatic 50%

Or severe

Dry cough, SOB

Question 4

Which groups are more commonly affected?

Answer 4

Woman more than men

Black people more than other ethnicities

Question 5

What pathologies does it cause in lungs?

Answer 5

Mediastinal lymphadenopathy
Pulmonary fibrosis
Pulmonary nodules

Question 6

What systemic symptoms occur in sarcoidosis? And what other organ systems can be affected?

Answer 6

Fever
Fatigue
Weight loss
Liver related symptoms (20%)
Eye related, uveitis (20%)
Skin (15%)
Heart (5%)
CNS, PNS

Question 7

What is loftgrens syndrome?

Answer 7

Sarcoidosis causing:

Bilateral hilar lymphadenopathy
Polyarthralgia
Erythema nodosum

Question 8

How is sarcoidosis diagnoses?

Answer 8

Blood tests checking ACE levels (increased)
Serum calcium (increased)
Soluble IL-2 (raised)
CRP and immunoglobulins

CXR for lymphadenopathy
High res CT

MRI for cns involvement

Pet scan for active inflammation areas

Biopsy (gold standard) (skin or bronchoscopy)

‘Non causeating granulomas with epithelioid cells’

Question 9

Management?

Answer 9

No treatment if mild

Oral steroids are first line for 6-24 months

2nd line immunosuppressive treatment

Lung transplant