sarcoidosis Flashcards
what is sarcoidosis
idiopathic multisystemic inflammatory disease characterised by non caseating granulomas and diffuse lung interstitial disease
with reticulin fibres
what is the aetiology of sarcoidosis
unknown
how to diagnose sarcoidosis
spirometry - normal even with chest abnormalities
restrictive
and obstructive
dico lowers
x ray /ct- symmetrical hilar and mediastinal lymphadenopathy , reticulonodular opacities
lung biopies- BRONCHO ALEVOLAR LAVAGE - bronchoscope they pour solution and take the solution back - mixture of sputum and cell and debris
20 percent lymphocytes
CD4:CD8 ratio greater than 3.5
EDOBRONCHIAL ULTRASOUND GUIDED BIOPSY
in both cases we see non caseating granulomas - cd4 t lymphocytes , epithelia cells ,langerhan cells and giant multinucleated cells
sampling intrathoracic lymph nodes by transbronchoscopic needle aspiration
what is the treatment for sarcoidosis ?
lofgren syndrome has good prognosis but - go into remission most times
organ impairment early on stage
usually mangled with bed rest and NSAIDS
initial stage 1 chest radiography also very strongly associated to remission
chronic sarcodosisi have progressive less remitting organ impairment
pateints in stage 4 - rarely go into remission
asymptomatic - no treatment
indication for treatment of sarcoidosis
threatened organ failure - eyes , cardiac and neurological disease
progressive and persistant pulmonary disease
uveitis unresponsive to topcal cortiocsteroids
corticosteroid therapy - predensol
antimalarial drugs- chloroquine - 500mg every other day
anti-inflammatory drugs - pentoixifyllin
immunoupperesants
methotrexate
antitumor necrosis factor agents - infliximab
what are the signs and symptoms for sarcoidosis ?
asymotomatic - hilar adenpathy
symptomatic pulmonary sarcoidosis -
cough - usually non productive
hemotpysus and sputum production - fibrocystic stage 4 sarcoidosis
and progressive dyspnea
bronchiectasis
acute onset of sarcoidosis seen lofgren syndrome- acute onset of fever , erythema nodosum , hilar adenopathy , polyartheritis , uveitis
10 percent have normal chest radiograph
what are the chest imaging stages for sarcoidosis ?
stage 0 - normal chest
stage 1 - hilar lymph adenopathy
stage 2 - bilateral lymph adenopathy , pulmonary infiltration
stage 3 - interstitial infiltrations - reticulonodular
hilar lymphadenopathy
stage 4 - extensive fibrocystic changes
what are the extra pulmonary sarcoidosis
URT
occular
cutaneous
what is a complication of sarcoidosis ?
cor pulmonale
