14 Pulmonary Granulomatous And Sacroidosis

Question 1

What is Pulmonary Granulomatosis?

Answer 1

Group of lung diseases with granuloma formation (immune cell clumps).

Causes: Sarcoidosis, TB, fungal infections, GPA (Wegener’s). Key Point: Must rule out infectious causes first.

Question 2

What is the definition of Sarcoidosis?

Answer 2

Chronic inflammatory disease with non-caseating granulomas in lungs, lymph nodes, and other organs.

Immune feature: ↑ CD4+ T-cells in lungs (CD4/CD8 ratio > 3.5)

Question 3

What are the symptoms of Sarcoidosis?

Answer 3

• Dry cough
• Dyspnea
• Fatigue
• Chest pain
• May involve: skin (erythema nodosum), eyes (uveitis), joints

Question 4

What is Lofgren’s Syndrome in Sarcoidosis?

Answer 4

Acute sarcoidosis triad:
✅ Erythema nodosum
✅ Bilateral hilar lymphadenopathy
✅ Fever & arthritis (usually ankles)
➡️ Good prognosis

Question 5

How is Sarcoidosis diagnosed?

Answer 5

• CXR: Bilateral hilar lymphadenopathy
• ACE ↑, Calcium ↑, CRP ↑
• Biopsy: Non-caseating granulomas
• Rule out TB/fungal causes

Question 6

What is the treatment for Sarcoidosis?

Answer 6

• First-line: Corticosteroids (Prednisone)
• Steroid-sparing: Methotrexate, Azathioprine
• Hydroxychloroquine (esp. for skin/eye)