Sarcoidosis

Question 1

What is Sarcoidosis?

Answer 1

Sarcoidosis is a chronic granulomatous disorder of unknown aetiology, commonly affecting the lungs, skin, and eyes. It is characterised by accumulation of lymphocytes and macrophages and the formation of non-caseating granulomas in the lungs and other organs.

Non caseating- no necrotic core

Question 2

What are the risk factors of sarcoidosis?

Answer 2

Aged 20-40
FHx sarcoidosis
Scandinavian origin
(Female, non smoker, black ancestry, puerto rican, european)

Immune dysregulation to allergen

Question 3

What is the epidemiology of sarcoidosis?

Answer 3

Incidence is about 6 cases per 100,000 person-years.

Question 4

What are the signs and symptoms of sarcoidosis?

Answer 4

RESPIRATORY SYMPTOMS
Cough
Dyspnoea
Wheezing
Rhonchi

SKIN
Lupus pernio
Erythema nodosum

NEUROLOGICAL
Blurred vision
Facial palsy
Hypercalcaemia symptoms 
Photophobia

GENERALISED
Chronic fatigue
Arthralgia
Lymphadenopathy
Red painful eye

Question 5

What investigations are used for sarcoidosis?

Answer 5

CXR
Hilar/ paratracheal adenopathy
Upper lobe predominant bilateral infiltrates
Pleural effusions
Egg shell calcifications

Bloods
FBC (Anaemia and leukopenia)
ESR (raised)
Urea and Creatinine (May be elevated)
Liver enzymes (elevated)
Serum calcium (Elevated)

Pulmonary Function Tests
Restrictive/ obstructive/ mixed

ECG
Conduction defects

Purified Protein derivative of tuberculin
Negative

Bronchoalveolar lavage
high CD4/CD8 ratio >3.5