Sarcoidosis Flashcards
What is the epidemiology of sarcoidosis
affects lungs in most cases
peaks earlier in men
peak for women is 50-60
afro-carribean is highest incidence
genetic predisposition
What is sarcoidosis
multisystemic granulomatous disease that can affect any organ in the body
characterised by formation of non-caseating granulomas
How may someone with sarcoidosis present
depends on organs affected
cough
SOB
fatigue
fever
night sweats
weight loss
skin rash
eye irritation
What may someone with sarcoidosis have on examination
lymphadenopathy
skin lesions
hepatosplenomegaly
signs of pulmonary fibrosis
What are risk factors for sarcoidosis
agricultural exposures
insecticides
mouldy environments
firefighters
SMOKING IS PROTECTIVE
What is stepwise plan of investigations for sarcoidosis
arrange CXR- may show bilateral hilar lymphadenopathy or pulmonary infiltrates
HRCT more sensitive and sometimes used
Blood tests -
can show hypercalcaemia ,ESR and serum ACE elevated
Spirometry - restrictive pattern
Tuberculin skin test -
NEGATIVE in patients with sarcoidosis
What is the staging for CXR for sarcoidosis
Stage 0 - normal
Stage 1- bilateral hilar lymphadenopathy
Stage 2 - BHL and interstitial infiltrates
Stage 3- diffuse interstitial infiltrates only
Stage 4- diffuse fibrosis
What is stepwise management for sarcoidosis
if asymptomatic with bilateral hilar lymphadenopathy -OBSERVE
if symptomatic stage 2,3,4
offer ORAL OR ICS
Consider treatment with topical corticosteroids
