Sarcoidosis

Question 1

Sarcoidosis: Define

Answer 1

Sarcoidosis is a multi-system Granulomatous disorder of unknown aetiology. It usually affects adults aged 20-40 yrs, and more so Females. African-Caribbeans are affected more severely and frequently than Caucasians. Sarcoidosis may cause hyperkalaemia and hypercalaemia.
Facial Rash & Lymphadenopathy - think Sarcoidosis.

Question 2

Sarcoidosis: Symptoms/Signs

Answer 2

Acute Arthralgia 
Bilateral Hilar Lymphadenopathy
Blurred Vision/Sore Eyes
Breathlessness
Cough 
Erythema Nodosum - red lumps on shins, or Lupus Pernio

Question 3

Sarcoidosis: Essential Investigations

Answer 3

Essential Investigations:
CXR
Kveim Test
Tuberculin Test
Serum ACE
Pulmonary FT

Question 4

Sarcoidosis: General Investigations

Answer 4

Bloods: FBC, LFT, Serum ACE
Bronchoscopy 
Bronchoalveolar Lavage BAL
CXR
PFT
ECG
Endobronchial US
TB Skin Test
HCRT
MRI
Mediastinoscopy 
VATS

Question 5

Sarcoidosis: Diagnosis

Answer 5

Clinical Finings
Imaging Findings
Serum Calcium & ACE
Biopsy
Kveim Test
Tuberculin Test

Question 6

Sarcoidosis: Treatment

Answer 6

Corticosteroids
Mild disease - no vital organ, normal lung function, few symptoms = no treatment
Erythma Nodosum, Actue Arthralgia = NSAIDS
Skin Lesions, Cough, Anterior Uveitis = Topical Steroids
Cardiac, Neurological, Hypercalcaemic,
Eye disease = Systemic Steroids e.g. Prednisilone