Sarcoidosis

Question 1

What type of cells are exaggerated in sarcoidosis? Major thing released?

Answer 1

Th1. TNF

Question 2

What is the probable pathogenesis

Answer 2

NOT AUTOIMMUNE. Ag release by mycobacteria, aggregation with macrophage proteins, T cell immune response leads to granulomas. Pt either clears it or you get more granulomas.

Question 3

What types of granulomas are there? What types of lymphocytes?

Answer 3

non-caseating. CD4 at center and CD8 at periphery

Question 4

What other organs does it invade?

Answer 4

all but most commonly skin and eyes and LNs

Question 5

Stage 1 CXR

Answer 5

Bilateral hilar lymphadenopathy- 60-90% remission

Question 6

Stage 2 CXR

Answer 6

BHL + parenchymal infiltrate- 40-70% remission

Question 7

Stage 3 CXR

Answer 7

parenchymal infiltrate w/o BHL- 10-20% remission

Question 8

Stage 4 CXR

Answer 8

End stage fibrosis- 0% remission

Question 9

Appearance on HRCT

Answer 9

Tree-in-bud opacities (peribronchovascular granulomas)

Question 10

finding on BAL

Answer 10

CD4/CD8 ration >3.5:1

Question 11

What are favorable findings?

Answer 11

fever, erythema nodosum (fat tissue necrosis of lower extremities), polyarthritis, BHL

Question 12

What is the Tx for sarcoidosis

Answer 12

corticosteroids