Sarcoidosis Flashcards
What is sarcoidosis?
A chronic granulomatous disorder
Who is sarcoidosis seen in?
Sarcoidosis can affect anyone. It seems to be slightly more common in:
Aged 20-39 or around 60
Women
Black ethnic origin
Skin features
Erythema nodosum is characterised by nodules of inflamed subcutaneous fat on the shins.
Lupus pernio is specific to sarcoidosis and presents with raised purple skin lesions, often on the cheeks and nose.
What organs does sarcoidosis affect?
All but mainly lungs
Symptoms of acute sarcoidosis
Aka Löfgren syndrome:
Fever
Polyarthralgia
Erythema nodosum
Bilateral hilar lymphadenopathy
Pulmonary: Dry cough, dyspnoea, reduced exercise tolerance, and crepitations on examination
Constitutional: Fatigue, weight loss, arthralgia, low-grade fever, 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
Chronic sarcoidosis symptoms:
Pulmonary
Pulmonary: Dry cough, dyspnoea, reduced exercise tolerance, and crepitations on examination
Constitutional: Fatigue, weight loss, arthralgia, low-grade fever, 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
Chronic sarcoidosis symptoms:
Pulmonary
Dry cough, dyspnoea, reduced exercise tolerance, and crepitations on examination
Chronic sarcoidosis symptoms:
General
Fatigue, weight loss, arthralgia, low-grade fever, lymphadenopathy, and enlarged parotid glands
Investigations
Definitive diagnosis through tissue biopsy
Chest X-ray results:
Stages 1-4
Stage 1 - Bilateral hilar lymphadenopathy (BHL)
Stage 2 - BHL with peripheral infiltrates
Stage 3 - Peripheral infiltrates alone
Stage 4 - Pulmonary fibrosis
Chest X-ray results:
Stages 1-4
Stage 1 - Bilateral hilar lymphadenopathy (BHL)
Stage 2 - BHL with peripheral infiltrates
Stage 3 - Peripheral infiltrates alone
Stage 4 - Pulmonary fibrosis
Treatment overview
Bilateral hilar lymphadenopathy alone: Usually self-limiting and often does not require treatment
Acute sarcoidosis: Bed rest and NSAIDs for symptom control
Steroid treatment: Oral or intravenous, depending on the severity of the disease
Immunosuppressants: Used in severe disease.
