Definition

Sarcoidosis is a chronic disease where there is an increase in the number of granulomas ( a small group of white blood cells + other tissue ). These granulomas can gather in several organs: eyes, lymph nodes, skin, lungs, and liver.  These cells can impair the normal function of several organs.

Aetiology

Unknown causes, however could be:

  • Genetic predisposition.

  • Environmental causes.

  • Exposure to some infections or chemicals.

  • Abnormal immune response.

Pathophysiology

Exposure to unknown antigen > immune response, however there is an overactive immune response > formation of granulomas.

Risk factors

  • Family history of sarcoidosis.

  • Ethnicity: Scandinavian or Africans are more at risk.

  • Exposure to certain environmental factors or occupations.

Sign and symptoms

  • Visual disturbances.

  • Coughing (persistent).

  • Shortness of breath.

  • Chest pain or discomfort.

  • Skin rashes or lesions.

  • Joint ache/pain.

Diagnosis and investigations

  • Good history and physical exam: check eyes, skin, joints and occupation.

  • Chest x-ray: bilateral hilar lymphadenopathy (BHL) is a common finding.

  • Blood test: full blood count (FBC), liver function test (LFT), electrolytes (UE). Note hypercalcaemia is a common finding.

  • ECG: arrhythmia may trigger further investigations.

  • CT scan.

  • Sputum sample: generally requested if there is suspicion of tuberculosis (TB).

Management

  • 90% patients don't require treatment as spontaneous remission occurs.

  • Medication treatment: simple analgesia such as paracetamol or NSAIDs, immunosuppressants and/or corticosteroids.

 
 
 

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