Sarcoidosis

Question 1

what age range is most affected by sarcoidosis?

Answer 1

20-40

Question 2

what gender is most affected by sarcoidosis ?

Answer 2

Females

Question 3

what genes are associated with sarcoidosis ?

Answer 3

HLA-DRB1 (MS) and DQB1 alleles

Question 4

what are the features of sarcoidosis? GRANULOMAS

Answer 4

general - fever, fatigue, lymphadenopathy, HSM, wt loss

resp - upper (otitis, sinusitis), lower (dry cough, SOB, chest pain, decreased lung function)

arthralgia - Polyarthralgia, Dactylitis

neuro - Peripheral and cranial polyneuropathy (esp. Bell’s palsy), Meningitis, transverse myelitis, SOL

urine - increased Ca (renal stones, nephrocalcinosis, DI)

Low hormones - Pituitary dysfunction: e.g. amenorrhoea

Ophthalmological - Uveitis, Keratoconjunctivitis, Sjogrens syndrome

Myocardial
􏰀 Restrictive cardiomyopathy 2O to granulomas + fibrosis
􏰀 Pericardial effusion

Abdominal
􏰀 Hepatomegaly + cholestatic LFTs
􏰀 Splenomegaly

Skin
Erythema Nodosum: painful erythematous nodules on shins (paniculitis)
Lupus pernio: raised, dusky purple plaque on nose, cheek, fingers

Question 5

what would blood results show for sarcoidosis ?

Answer 5

􏰀 ↑ESR
􏰀 ↑Ca
􏰀 Lymphopenia 
􏰀 ↑seACE
􏰀 ↑Ig
􏰀 ↑LFTs

Question 6

what investigations can be done for sarcoidosis ?

Answer 6

bloods 
CXR, CT, MRI
Tuberculin skin test
Lung function test (restrictive pattern)
Tissue biopsy 
Ophthalmology assessment

Question 7

what is the treatment for acute sarcoidosis ?

Answer 7

􏰁 Usually resolves spontaneously

􏰁 Bed rest and NSAIDs

Question 8

what is the treatment for chronic sarcoidosis ?

Answer 8

􏰁 Steroids: pred 40mg/d for 4-6wks
􏰁 Additional immunosuppression: methotrexate,
ciclosporin, cyclophosphamide

Question 9

what are some DD for Bilateral hilar lymphadenopathy ?

Answer 9

􏰀 Infection: TB, mycoplasma
􏰀 Malignancy: lymphoma, carcinoma
􏰀 Interstitial disease: EAA (Extrinsic allergic alveolitis), silicosis

Question 10

what are some DD for granulomatous disease?

Answer 10

􏰀 Infections: TB, leprosy, syphilis, crypto, schisto
􏰀 AI: PBC
􏰀 Vasculitis: GCA, PAN, Wegener’s, Takayasu’s
􏰀 Idiopathic: Crohns, Sarcoid
􏰀 Interstitial lung: EAA, silicosis