Sarcoidosis Flashcards
Define sarcoidosis
Chronic noncaseating granulomatous disorder of unknown aetiology, affecting lungs, skin and eyes
Aetiology
Genetics - being an African American female, FH
Enviro:
Mycobacterium tuberculosum
Borellia burgdorfelli
Epidemiology
African American females and Scandinavians
Presents between 20s and 40s, peaks in third and fifth decade
What is meant by granulomatous?
This means there are macrophages surrounded by T cells, deposited in certain areas
What is meant by non-caseating?
There is no necrosis in the centre of the deposits, unlike in certain other disorders
What happens to the macrophages?
They fuse together to form a giant Langerhans cell
What is found inside these Langerhan cells?
Schaumann bodies
Asteroid bodies
What are Schaumann bodies?
Calcium deposits
What are Asteroid bodies?
Lipid/cytoskeleton deposits (noone knows)
How do you test for sarcoidosis?
Kveim test
Spleen biopsy is taken from a person with known sarcoidosis, and this is injected into the skin of someone with suspected sarcoidosis. If a nodule appears 4-6 weeks later, this is positive for sarcoidosis
Name a differential for sarcoidosis
Berylliosis - exposure to beryllium in the workplace (aerospace areas) can cause restrictive pneumoconiosis with similar symptoms to sarcoidosis, but the Kveim test is negative
Symptoms of sarcoidosis
Lungs:
Non-productive cough
Dyspnoea that worsens
Wheeze
Eyes: Red painful eye Photophobia Blurred vision Keratoconjunctivitis sicca
Cardiac: Arrhythmia BBB Congestive heart failure Cardiomyopathy Pericarditis
Other: Chronic fatigue Arthralgia Fever Weight loss
Skin:
Erythema nodosum
Neuro: Lymphocytic meningitis Space-occupying lesions Pituitary infiltration Cerebellar ataxia Cranial nerve palsies Peripheral neuropathy
Signs
Ronchi sounds???
Bilateral hilar lymphadenopathy
Erythema nodosum
Lupus pernio
Describe erythema nodosum nodules
Red, hard, painful
Inflammation of skin fat
What is lupus pernio
Skin nodules/inflammation on nose, cheeks, ears and terminal phalanges
