Prognosis case - Sarcoidosis

Question 1

Nonproductive cough - top 3

Answer 1

GERD, postnasal drip, asthma

Question 2

Sarcoidosis is

Answer 2

Noncaseating granulomas, multi-system
Lungs predominantly effected
All organs can be effected

Question 3

Etiology sarcoidosis

Answer 3

None

Immune response to environmental factors in genetically susceptible people

Question 4

1/3 of sarcoidosis present with what syndrome

Answer 4

Lofgren syndrome

Question 5

Lofgren syndrome is

Answer 5

Arthritis, erythema nodosum, fleeting arthritis, fever, bilateral hilar adenopathy

Question 6

Dx of sarcoidosis

Answer 6

Symptoms, CXR, histological diagnosis by trans bronchial lung biopsy
FDG-PET to see other involved sites for biopsy
Serum ACE 2x normal
Gallium 67 enhancement
CD4/CD8 ratio on BAL

Question 7

Treatment of sarcoidosis

Answer 7

PFTs for baseline lung function
Eye exams, all labs to see baseline organ function
Steroids 6-24 months, dose depends on organ affected
Methotrexate if fail steroid, or for steroid-sparing

Question 8

Prognosis of sarcoidosis

Answer 8

Mostly self-limiting
Resolution 2-5 years
Some are chronic
Mortality 1-5%