sarcoidosis Flashcards
What is sarcoidosis?
Multisystem (e.g. heart, liver, kidneys) granulomatous disorder of unknown cause
What 2 types of people does sarcoidosis occur in?
- Younger adults
- patients with pathological background of type lV hypersensitivity reaction -> leading to granuloma formation
what 5 presentations are found in acute sarcoidosis?
- Breathlessness
- cough
- fatigue
- weight
- erythema nodosum (red inflamed patches on shins etc.)
what 4 presentations are found in chronic sarcoidosis (features of pulmonary fibrosis)?
- chronic breathlessness and cough,
- clubbing
- fine end inspiratory crackles
- right heart failure
what 2 presentations will you find in extrapulmonary features of sarcoidosis?
- Anterior uveitis (inflamed red eye)
- arthralgia (joint pain)
what 4 presentations will you find in lotgren sydrome?
- Arthralgia (ankle)
- bilateral hilar lymphadenopathy
- erythema nodosum
- fever
What are 2 things are blood tests used to find in sarcoidosis?
Raised serum angiotension-converting enzyme (ACE) unique
- hypercalcaemia in sarcoidosis
-> due to uncontrolled synthesis of 1,2 5 – dihydroxyvitamin D3 by macrophages
what do you find a chest x ray with acute sarcoidosis?
bilateral hilar lymphadenopathy
What do you find in chronic sarcoidosis chest x-ray?
fibrosis
what do you exclude in a chest x-ray?
Tuberculosis
what else do you look for in a chest x-ray that has sarcoidosis?
RO
reticular opacities, especially in upper zones
why is spirometry used in sarcoidosis?
- usually normal
- might show obstructive/restrictive patterns non-car seat in the granuloma
what might a biopsy show in a sarcoidosis investigation?
non-caseating granuloma
what is glucocorticoids use for an sarcoidosis treatment?
Intolerable symptoms, lung disease or extrapulmonary symptoms
What is immuno suppression used for in sarcoidosis treatment?
- steroid resistance
- deteriorating symptoms