Sarcoidosis

Question 1

Define sarcoidosis

Answer 1

Chronic granulomatous multisystem disorder, characterised by the accumulation of T lymphocytes and macrophages and non-caveating granuloma formation

Question 2

Aetiology of sarcoidosis

Answer 2

Unknown

Suggested transmissible agents, environmental triggers and genetic fractors

Question 3

Risk factors of sarcoidosis

Answer 3

20-40, >50
FHx
Female
Non-smoker
Scandinavian, afro-carbbean 
Agricultural exposure, insecticides

Question 4

Presenting symptoms of sarcoidosis

Answer 4

General: malaise, fever, weight loss, parotid swelling, lymphadenopathy

Lungs (90%): SOB, dry cough, chest discomfort, wheeze

MSK: Bone pain, arthralgia

Eyes: Dry eyes and swelling/pain in one eye, photophobia

Skin: Red-blue rashes on the nose, cheek, terminal phalanges

Cardiac: chest pain

Question 5

Signs of sarcoidosis

Answer 5

lungs: minimal

MSK: Bone cysts, polyarthralgia

Eyes: keratoconjunctivitis, Uveitis, papulloedema

Skin: Lupus pernio, erythema nodosum

Heart: arrhythmia, Heart failure, BBB, pericarditis etc.

Question 6

Investigations for sarcoidosis

Answer 6

Pulmonary function tests (restrictive picture)
ECG

FBC (WCC reduced)
ACE (raised)
CRP/ESR (Raised)
U+Es (hypercalcaemia)
LFTs (ALP and GGT raised)

CXR: bilateral hilar lymphadenopathy
HRCT: diffuse lung involvement

Biopsy: non-caveating granulomas

Question 7

Management of sarcoidosis

Answer 7

Steroids
Steroid-sparing agents
NSAIDs