Sarcoidosis

Question 1

What skin signs?

Answer 1

Erythema Nodosum

Question 2

What ethnicity?

Answer 2

Black

Question 3

What chest signs?

Answer 3

Mediastinal lymphadenopathy
Pulmonary fibrosis
Pulmonary nodules

Question 4

How does heart change?

Answer 4

BBB

Heart block

Question 5

Eye signs in sarcoidosis?

Answer 5

Optic neuritis
Uveitis
Conjuctivitis

Question 6

Liver sarcoidosis

Answer 6

Liver nodules
Cirrhosis
Cholestasis

Question 7

Neurological sarcoidosis

Answer 7

Facial nerve palsy
Mononeuritis multiplex
Nodules
Pituitary involvement (diabetes insipidus)
Encephalopathy

Question 8

Kidney sarcoidosis

Answer 8

Kidney stones (due to hypercalcaemia)
Nephrocalcinosis
Interstitial nephritis

Question 9

Systemic symptoms of sarcoidosis

Answer 9

Fatigue
Weight loss
Fever

Question 10

What Ix for sarcoidosis

Answer 10

U&Es for kidney involvement
Urine dipstick or urine albumin-creatinine ratio to look for proteinuria indicating nephritis
LFTs for liver involvement
Ophthalmology review for eye involvement
ECG and echocardiogram for heart involvement
Ultrasound abdomen for liver and kidney involvement

Question 11

How to manage sarcoidosis

Answer 11

No treatment is first line
Oral steroids for between 6 and 24 months. Bisphosphonates
Second line options are methotrexate or azathioprine
Lung transplant is rarely required in severe pulmonary disease

Question 12

What is prognosis

Answer 12

Sarcoidosis spontaneously resolves within 6 months in around 60% of patients.
Small proportion lung transplant.
Death in sarcoidosis is usually when it affects the heart (causing arrhythmias) or the central nervous system.