Sarcoidosis

Question 1

What forms around the body in sarcoidosis?

Answer 1

Non-caseating granuloma

Question 2

What is often raised in sarcoidosis?

Answer 2

ACE

Calcium

Question 3

What skin sign is seen in sarcoidosis?

Answer 3

Erythema nodosum

Question 4

What is the characteristic CXR finding for sarcoidosis?

Answer 4

Bilateral hilar lymphadenopathy

Question 5

What are some of the features of acute sarcoidosis?

Answer 5

Fever
Erythema nodosum
Polyarthralgia
BHL on CXR (90%)

Usually resolves spontaneously

Question 6

What ethnicity is more commonly affected by sarcoidosis?

Answer 6

Afro-carribean

Question 7

What pulmonary symptoms does sarcoidosis cause?

Answer 7

Sarcoidosis is a cause of ILD which leads to:
Dry cough
Exertional dyspnea
Clubbing if chronic
Fibrotic change on CXR and HRCT
Reduced TLCO

Question 8

What investigations might be done for sarcoidosis?

Answer 8

Bloods- 
ACE
ESR
CRP
FBC
Calcium
LFTs

Urine
- 24 hour urine shows raised calcium

CXR- BHL
HRCT- Fibrotic change (Honeycombing) and BHL
Spirometry
Bronchoalveolar lavage (shows elevated T cells in sarcoid and hypersensitivity pneumonitis)

Biopsy-
Non-caseating granuloma (unlike TB)
May biopsy lymph nodes, lung, skin…

Imaging-
CT/MRI

Question 9

What are the features of erythema nodosum?

Answer 9

Hard painful inflammatory nodules often on the skin

Question 10

What ocular effects might sarcoidosis cause?

Answer 10

Uveitis

Question 11

What cardiac effects might sarcoidosis cause?

Answer 11

Arrhythmia - granulomas can interfere with conducting system.

Question 12

Why might sarcoidosis cause loin to groin pain?

Answer 12

Hypercalcaemia increases the risk of developing renal stones

Question 13

What are some of the indications for steroid treatment for sarcoidosis?

Answer 13

Severe features
Eye involvement- uveitis
Neurological or cardiac involvement
Lung disease
Hypercalcaemia