sarcoidosis Flashcards
define sarcoidosis?
● Multisystem granulomatous inflammatory disorder of unknown cause
what does granulomatous mean?
a granuloma is a collection of macrophages
what does non-caseating mean?
caseation refers to a form of necrosis that appears cheese-like whereas non-caseating means there has been no necrosis.
what condition causes casaeting granulomas?
TB
what is the cause of sarcoidosis?
● UNKNOWN
● Associated with HLA-DRB1 and DQB1 alleles
what is the pathogenesis of sarcoidosis?
o An UNKNOWN antigen is presented on MHC class 2 complexes on macrophages to CD4+ T-lymphocytes o These accumulate and release cytokines o This leads to the formation of non-caseating granulomas in organs
epidemiology of sarcoidosis?
● Most common in AFRICANS and SCANDINAVIANS
● More common in women
● Common between 20-40 years
acute symptoms of sarcoidosis?
o Erythema nodosum (painful leg lumps)
o Bilateral hilar lymphadenopathy (lung lymph nodes enlarged)
o Swinging fever
o Polyarthralgia (pain in joints)
insidious symptoms of sarcoidosis?
o Dyspnoea o Non-productive cough o Malaise o Weight loss o Lupus pernio • Hypercalcaemia
what might the bloods show in sarcoidosis?
o High serum ACE in 60% o High calcium o High ESR o FBC - WCC may be low o High Immunoglobulins o LFTs - high ALP + GGT
what is the staging of sarcoid on a CXR?
o Stage 0 - may be clear
o Stage 1 - bilateral hilar lymphadenopathy
o Stage 2 - stage 1 with peripheral pulmonary infiltration and paratracheal node enlargement
o Stage 3 – peripheral pulmonary infiltration alone
o Stage 4 - pulmonary infiltration and fibrosis, bulla formation (honeycombing), pleural involvement
what other tests might be used?
● High-Resolution CT Scan ● Gallium Scan ● Pulmonary Function Tests ● Bronchoscopy ● Transbronchial Lung Biopsy
