Flashcards in Sarcoidosis Deck (18)
what is sarcoidosis?
a non-caseating granulomatous (type 4 hypersensitivity) disease of unknown cause
The cause is unknown but what might be involved?
- an ineffective agent in a susceptible individual.
- imbalance of immune system with type 4 hypersensitivity
who is it less and more common in?
-less common in smokers
- more common in afro-caribbean populations
there is multisystem involvement which are the common and uncommon sites of involvement?
common: lungs, lymph nodes, joints, liver, skin, eyes
uncommon: kidneys, brain, permanent damage
what are the symptoms for acute sarcoidosis?
over the course of a week or two you will start to feel generally unwell and will often develop erythema nodosum
- erythema nodosum
- bilateral hilar lymphadenopathy
- parotitis (inflammation of the salivary glands)
what are the symptoms and characteristics of chronic lymphadenopathy
- lung infiltrates (alveolitis)
- skin infiltrations
- peripheral lymphadenopathy
- can get end-organ damage such as renal, myocardial, neurological, hepatitis, splenomegaly
what should be on the differential diagnosis
- TB (tuberculin skin test negative)
- fungal infection
what investigations should be done to lead to a diagnosis?
- tissue biopsy
- blood test
what would the CXR show?
bilateral hilar lymphadenopathy, nodules along fissures
what would a CT show maybe?
peripheral nodular infiltrate
tissue biopsy ?
(e.g. transbronchial, skin, lymph node)
what would the blood tests show?
- raised calcium
- increased inflammatory markers
- renal function
what are the severity marker investigations ?
ANGIOTENSIN CONVERTING ENZYME: act as an activity marker. This is NOT a diagnostic marker as it is quite non-specific
PULMONARY FUNCTION: restrictive defect due to lung infiltrations.
- this is really to see how affected the patient is by the disease
What is the treatment for acute sarcoidosis
it is a self limiting condition so usually no treatment is administered-but treat the other multisystem involvement
what is given in acute S if a vital organ is affected?
which problem needs steroid treatment and why?
uveitis: because patients can end up with permanent damage
what is the treatment for chronic sarcoidosis ?
This does need treatment oral steroids if vital organ is affected (e.g. lungs, eyes, heart, brain)
they are given prednisolone or steroid sparing drugs