Sarcoidosis

Question 1

Define sarcoidosis

Answer 1

Multisystem granulomatous disorder of unknown cause. It can affect the heart, the lungs, the kidneys, the joints, the skin etc

Question 2

How do you stratify severity of lung disease due to sarcoidosis?

Answer 2

Depends on CXR

Stage 0: Normal

Stage 1: BHL

Stage 2: BHL + parenchymal infiltration

Stage 3: parenchymal infiltration

Stage 4: pulmonary fibrosis

Question 3

Explain the aetiology/ risk factors of sarcoidosis

Answer 3

Causes:

• Cause is mostly UNKNOWN
• Could have environmental, viral and genetic triggers
• MHC class 2 macrophages present an unknown antigen to CD4 which release cytokines and form non-caseating granulomas in the organs

Risk factors:

• age 20 to 40 years
• FHx sarcoidosis
• female gender
• non-smokers
• Black, Puerto Rican, European descent

Question 4

Summarise the epidemiology of sarcoidosis

Answer 4

More common in AFRICANS and SCANDINAVIANS

Age: 20-40

F>M

HLA-DRB1 and DQB1 alleles

Question 5

Recognise the presenting symptoms of sarcoidosis

Answer 5

GRANUMOLAS

General: fever, malaise, wt, fatigue

Respiratory: dry cough, SOB, CP

Arthralgia: polyarthrlagia, myopathy

Neurological: weakness, pins and needles, coordination

Urine:

Low hormones: amenorrhoea

Ophthalmology: pb with eyes

Myocardial: palpitations, CP

Abdominal

Skin: painful erythamtous noludles on shin