Sarcoidosis Flashcards
Characteristic feature of sarcoidosis
non-caseating granulomas
Demographic usually affected by sarcoidosis
young adults
African descent
non-acute features of sarcoidosis
- polyarthralgia
- SOB
- non-productive cough
- weight loss
- uveitis
- lupus pernio
- hypercalcaemia
Acute features of sarcoidosis
- erythema nodosum
- bilateral hilar lymphadenopathy
- swinging fever
How does sarcoidosis cause hypercalcaemia?
macrophages inside the granulomas cause an increased conversion of vitamin D to its active form (1,25-dihydroxycholecalciferol)
Name the acute form of the disease characterised by bilateral hilar lymphadenopathy (BHL), erythema nodosum, fever and polyarthralgia. It usually carries an excellent prognosis
Lofgren’s syndrome
Name the syndrome where there is enlargement of the parotid and lacrimal glands due to either sarcoidosis, tuberculosis or lymphoma.
Mickulicz syndrome
Name the syndrome where there is parotid enlargement, fever and uveitis secondary to sarcoidosis
Heerfordt’s syndrome (uveoparotid fever)
investigations used to diagnose sarcoidosis
Bloods
- hypercalcaemia
- raised inflammatory markers
- ACE levels (more useful in monitoring)
CXR
spirometry = restrictive
tissue biopsy: non-caseating granulomas
gallium-67 scan
Describe Stage 1-4 of sarcoidosis on CXR
stage 1 = bilateral hilar lymphadenopathy (BHL)
stage 2 = BHL + interstitial infiltrates
stage 3 = diffuse interstitial infiltrates only
stage 4 = diffuse fibrosis
Management of sarcoidosis
Steroids
Indications for steroid treatment
- CXR stage 2/3 and symptomatic
- hypercalcaemia
- eye, heart or neuro involvement
Sarcoidosis remits without treatment in approximately 2/3 of people. TRUE/FALSE
TRUE
Factors associated with poor prognosis
- insidious onset (> 6 months)
- absence of erythema nodosum
- extrapulmonary manifestations: e.g. lupus pernio, splenomegaly
- CXR: stage 3/4
- black African or African–Caribbean ethnicity
