Sarcoidosis Flashcards
What is sarcoidosis?
multisystem chronic inflammatory condition characterised by formation of non-caseating epithelioid granulomata
In order of predilection, which organs are effected by sarcoidosis ?
Lungs + thoracic cavity Skin + eyes Liver Heart Nervous system.
Give 3 epidemiological facts on sarcoidosis
Most common in Northern European/Scandinavian + African-American individuals.
Usually in adults < 50
Usually sporadic
What are 6 constitutional symptoms that may be experienced by a patient with sarcoidosis?
Fever Night sweats Malaise Fatigue Weight loss. Heerfordt's syndrome (inflammation of submaxillary/ parotid glands with uveitis + facial nerve palsy)
List 3 respiratory symptoms seen in sarcoidosis
Dry cough
Dyspnoea
Chest discomfort.
List 3 skin manifestations
Maculopapular eruptions Erythema nodosum Lupus pernio (red-blue infiltrations of nose + cheeks)
List 3 musculoskeletal manifestations in sarcoidosis
Bone cysts (e.g. dactylitis)
Polyarthralgia
Myopathy
List 4 ocular manifestations in sarcoidosis
Dry eyes
Glaucoma
Uveitis
Blurred vision
What is Neurosarcoidosis caused by? What may this result in?
Infiltrative nerve lesions: Lymphocytic meningitis Cranial nerve palsies: Bells palsy Peripheral neuropathy Facial numbness
List 3 cardiac manifestations of sarcoidosis
Arrhythmia
Cardiomyopathy
Congestive heart failure
What will be seen in the bloods of a patient with sarcoidosis?
High serum ACE
High calcium
High ESR
FBC: WCC low due to lymphocyte sequestration in the lungs
Immunoglobulins: polyclonal hyperglobulinaemia
LFTs: high ALP + GGT
What is found in 24 hr urine collection in sarcoidosis?
Hypercalciuria
Describe the staging of sarcoidosis based on CXR findings
Stage 0: normal Stage 1: bilateral hilar lymphadenopathy Stage 2: BHL + pulmonary infiltrates Stage 3: pulmonary infiltrates, no BHL Stage 4: overt fibrotic disease
What can high resolution CT scanning show in sarcoidosis?
Interstitial lung disease
What do pulmonary function tests show in sarcoidosis?
Low FEV1
FVC shows restrictive picture
What is found on bronchoscopy/ bronchiavleolar lavage in sarcoidosis?
High lymphocytes
High CD4: CD8 ratio
What is seen on transbronchial/ lymph node biopsy in sarcoidosis?
Non-caseating granulomas consisting of: Epithelioid cells (activated macrophages) Multinucleate Langerhans cells Mononuclear cells (lymphocytes)
What is the standard first line treatment for sarcoidosis?
Oral glucocorticoids
What are 3 environmental risk factors for development of sarcoidosis?
Agricultural exposure
Insecticides
Microbial bioaerosols
Name 1 protective factor against sarcoidosis
Cigarette smoking
List 4 markers of poor prognosis in sarcoidosis
Pulmonary HTN
Extensive disease
Lung function impairment
Age
