Sarcoidosis Flashcards
(12 cards)
What is sarcoidosis?
Sarcoidosis is a chronic multisystem granulomatous disease of unknown etiology, characterized by non-caseating granulomas, most commonly affecting the lungs and intrathoracic lymph nodes.
What are the common systems affected by sarcoidosis?
• Respiratory (lungs, hilar/mediastinal lymph nodes)
• Skin
• Eyes
• Liver & spleen
• Heart
• Nervous system
What are the respiratory features of sarcoidosis?
• Dry cough
• Progressive dyspnea
• Chest discomfort or pain
• Hilar lymphadenopathy on CXR
• Restrictive lung pattern on spirometry
What are the skin manifestations?
• Erythema nodosum (tender red nodules, especially shins)
• Lupus pernio (chronic indurated plaques on the nose, cheeks, ears)
• Maculopapular rash
What ocular complications can occur?
• Anterior uveitis (red painful eyes, photophobia)
• Conjunctival nodules
• Lacrimal gland enlargement → dry eyes
What is Löfgren’s syndrome?
An acute presentation of sarcoidosis characterized by:
• Erythema nodosum
• Bilateral hilar lymphadenopathy
• Fever
• Arthralgia
It has a good prognosis.
What is Heerfordt’s syndrome?
A rare form of sarcoidosis presenting with:
• Uveitis
• Parotid gland enlargement
• Facial nerve palsy
• Fever
How is sarcoidosis diagnosed?
• Clinical features and exclusion of other causes
• CXR: Bilateral hilar lymphadenopathy
• HRCT chest: Interstitial infiltrates, fibrosis
• Biopsy of affected tissue: Non-caseating granulomas
• Blood tests: ↑ ACE, ↑ calcium, ↑ ESR, lymphopenia
• Pulmonary function test: Restrictive pattern
• Tuberculin test: Often negative (anergy)
What are the indications for treatment?
• Progressive pulmonary disease
• Eye involvement
• Cardiac or CNS involvement
• Hypercalcemia
• Disfiguring skin lesions
What is the mainstay of treatment?
• Oral corticosteroids (e.g., prednisolone)
• Steroid-sparing agents: methotrexate, azathioprine, hydroxychloroquine
• Biologics (in refractory cases): infliximab
How is pulmonary sarcoidosis staged radiologically?
• Stage 0: Normal CXR
• Stage 1: Bilateral hilar lymphadenopathy (BHL) only
• Stage 2: BHL + pulmonary infiltrates
• Stage 3: Pulmonary infiltrates without BHL
• Stage 4: Pulmonary fibrosis
What are key points to remember during MRCP PACES communication station for sarcoidosis?
• Explain that it is not cancer and often resolves spontaneously.
• Emphasize multisystem involvement, but many cases are asymptomatic.
• Inform the patient about need for monitoring and regular eye/chest exams.
• Discuss the side effects of corticosteroids if treatment is needed.
• Reassure about generally good prognosis in early or limited disease.
