Sarcoidosis

Question 1

How does sarcoidosis typically present?

Answer 1

Resp:
- SOB
MSK/Skin:
- non-specific joint pain
- erythema nodosum
Neuro:
- CN palsies (bilat FN, LMN)

Question 2

What is the first-line investigation for sarcoidosis?

Answer 2

Bronchoscopy + transbronchial lung biopsy

Question 3

What is indicative of sarcoidosis on biopsy?

Answer 3

Non-caseating granulomas + epithelioid cells

Question 4

What is Loefgren’s syndrome?

Answer 4

Acute clinical presentation of sarcoidosis triad:
- fever
- BL hilar lymphadenopathy
- erythema nodosum (dark bumps)
- polyarthalgia

(Not to be confused with migratory polyarthritis)

Question 5

Toxoplasmosis

Answer 5

Parasite causing flu-like symptoms, differential of sarcoidosis self-resolving in 6w
- see GP if pregnant

(cat poo, meat)

Question 6

Histoplasmosis

Answer 6

Fungus causing flu-like symptoms + chills, chest pain, differential of sarcoidosis
- severe if spreads to lungs & SC

(Bird/bat droppings)

Question 7

Treatment of sarcoidosis

Answer 7

Oral steroids (Prednisolone)
Bisphosphonates - protect OP due to long term steroids
Rare lung transplantation

Question 8

Prognosis of sarcoidosis

Answer 8

60% spontaneously resolve in 6m
Pulmonary fibrosis & PHTN = lung transplantation
Death - arrhythmias/CNS