Sarcoidosis Flashcards
Sarcoidosis
Chronic granulomatous disorder of unknown cause
Type of granulomas
Non-caseating granulomas
Type of Hypersensitivity
IV - delayed hypersensitivity
Common systems involved
Lungs, lymph nodes, joints, liver, skin, eyes
What causes tissue damage & fibrosis?
Persistent immune activation
Pathology
Inhalation of unknown antigen => stimulates alveolar macrophages, CD4+ & CD8+ T cells & B cells within lung parenchyma => failure to clear antigen caused persistent stimulation & granuloma formation => Persistent immune activation leads to tissue damage & fibrosis, particularly in upper lobes.
Persons affected
- Adults aged 20-40.
- More common in female & Afro-Caribbean.
- Highest in Northern Europe.
- Less common in smokers.
Symptoms of Acute Sarcoidosis
- Erythema nodosum.
- Bilateral hilar lymphadenopathy.
- Arthritis.
- Uveitis.
- Parotitis.
- Fever.
Symptoms of Chronic Sarcoidosis
- Lung infiltrates (alveolitis).
- Skin infiltrates.
- Peripheral lymphadenopathy.
- Hypercalcaemia.
General Symptoms
- Weight loss.
- Malaise.
- Polyurethaning.
- Rash.
- Bihilar lymphadenopathy.
- Polyarthiritis.
- Erythema nodosum.
Respiratory Symptoms
- Dry cough.
- Progressive dyspnoea.
- Reduced exercise tolerance.
- Chest pain.
Investigations
CXR, spirometry, DCLO, CT lungs, Tissue biopsy, blood test.
CXR
- Bilateral hilar lymphadenopathy.
- Pulmonary infiltrates or fibrosis.
Spirometry
Normal restrictive pattern
DCLO
Normal or reduced