PD12.4: Sarcoidose

Question 1

welke leeftijdsgroep hoogste sarcoidose prevalentie

Answer 1

volwassenen < 40, vaakst in winter en vroege lente

Question 2

occupational clustering sarcoidose

Answer 2

• naval aircraft service men
• fire fighters
• health care workers

Question 3

sarcoidose

Answer 3

• granulomateuze inflammatoire ziekte met onbekende origine
• kveim reaction: inductie van humaan granulomateus materiaal

Question 4

sarcoidose patho

Answer 4

• productie van 1,25 OH vitD => Ca2+
• productie van groeifactoren => fibrose
• productie ACE
• productie IL-2R
• TNF-alfa

Question 5

waaruit bestaat een granuloom?

Answer 5

T-cellen aan de buitenkant, macrofagen aan de binnenkant

Question 6

plekken van uiting sarcoidose

Answer 6

• huid
• ogen
• gewrichten
• longen

Question 7

defect in nucleotide binding domein …

Answer 7

van CARD51/NOD2

Question 8

symptomen sarcoidose

Answer 8

• Fatigue
• Anorexia
• Weight loss
• Fever
• Dyspnea
• Retrosternal chest pain
• Cough
• Organ specific clinical signs

Question 9

organ involvement sarcoidose

Answer 9

• luchtwegen 100%
• lymfatische systeem 90%
• lever 40-70%
• huid 25%
• ogen 15-25%
• zenuwstelsel 5%

Question 10

löfgren’s syndroom

Answer 10

Erythema nodosum
Arthritis
Bilateral hilar lymphomas

Question 11

sarcoidose in de longen

Answer 11

• granulomen nabij de pleura
• reuscellen, lymfocyten, epitheloid cellen

Question 12

AO sarcoidose

Answer 12

• Bronchoalveolar lavage fluid: increased T lymphocyte numbers,
  predominantly CD4 positive T cells
• Peripheral blood: lymphopenia

Question 13

oculaire sarcoidose

Answer 13

• vasculitis
• uveitis

Question 14

endocriene klieren betrokken bij sarcoidose

Answer 14

• thyroid
• pitiutary
• male genital tract
• female genital tract

Question 15

Sarcoidosis and pregnancy

Answer 15

Improvement: 62%
Stable disease: 31%
Relapse: 7%

Question 16

diagnose sarcoidose

Answer 16

No specific test!!!!!!!!
- Biopsia: noncaseating granulomas
-In the absence of a causative agent
Recommended:
- Exposure interview
- Chest X-ray
- ECG
- Ophthalmological examination
- Ca++ , hepatic, renal function
- Pulmonary function test, DCO!!, TLC, VC
- Organ specific investigation
- ACE

The diagnosis of sarcoidosis is based on combined clinical,
radiologic and histologic findings.
Laboratory tests are seldom important in the diagnosis.

Question 17

aspecifiek

Answer 17

• ACE
• IL2R

Question 18

When should sarcoidosis
be treated?

Answer 18

• treatment not in every case necessary
• in some cases treatment mandatory:
  – risk organ damage localisation hart,
  eye, and/or central nervous system
  – hypercalcemia
  – mortality
• use corticosteroids controversial:
  – effective form of treatment
  – association with significant toxicity

Question 19

behandeling sarcoidoes

Answer 19

➔ Corticosteroids:
➔ Methotrexate (MTX):
➔ Azathioprine (AZA):
➔ Mycophenylate:
➔ TNF blokkade:
➔ Hydroxychloroquine