Sarcoidosis

Question 1

What are the features of sarcoidosis?

Answer 1

non-caseating granulomas more common in young adults and people of African descent

• Acute: Erythema nodosum, bilateral hilar lymphadenopathy, swinging fever, polyarthralgia
• Insidious: Dyspnoea, non-productive cough, malaise, weight loss
• Skin: Lupus pernio (purple skin lesion)
• Hypercalcaemia: the macrophages convert Vit D to its active form

Question 2

What are the investigations for Sarcoidosis?

Answer 2

Largely clinical diagnosis

CXR: Most severe stage (Stage 4) shows diffuse fibrosis
Other investigations: Spirometry (restrictive defect), tissue biopsy

Question 3

What is the management for Sarcoidosis?

Answer 3

Patient with CXR of stage 2/3 and symptomatic require steroids. Hypercalcaemia, eye, heart or neuro involvement also require steroids.