SARCOIDOSIS

INTRODUCTION (1)
Sarcoidosis is an inflammatory disease that affects one or more organs but most
commonly affects the lungs and lymph glands. As a result of the inflammation,
abnormal lumps or nodules (called granulomas) form in one or more organs of
the body. These granulomas may change the normal structure and possibly the
function of the affected organ(s).
(2)(4)
Causes
* The exact cause of sarcoidosis is not known. The disease can appear suddenly
and then disappear, or it can develop gradually and produce symptoms that
come and go for a lifetime.
•Researchers believe that the disease is caused by an abnormal immune
response. (The body’s defense system does not react as it should to a foreign
substance "intruder.") In a healthy person, inflammation occurs as the cells of
the body’s immune system come together to fight the intruder at an organ or
tissue site.
• In a person with sarcoidosis, however, cells that come to fight end up
clumping together into small lumps called granulomas.
* It’s still uncertain which foreign substance "triggers" the body’s abnormal
response. Some researchers suggest that fungi, viruses, or bacteria are likely
triggers. In fact, cases of sarcoidosis have occurred in groups of people who had
close contact with each other, as well as in recipients of heart, lung and bone
marrow transplants.
* But, so far, no data have been able to convincingly and consistently establish this
"infectious" connection as the cause of the disease. However, some types of bacteria
.have recently emerged as possible candidates and continue to be closely studied

symptoms (3)
The symptoms of sarcoidosis can vary greatly, depending on which organs are •
involved. Most patients initially complain of a persistent dry cough, fatigue, and
:shortness of breath. Other symptoms may include
• Tender reddish bumps or patches on the skin.
• .Red and teary eyes or blurred vision
• .Swollen and painful joints
• .Enlarged and tender lymph glands in the neck, armpits, and groin
• .Enlarged lymph glands in the chest and around the lungs
• .Hoarse voice
Pain in the hands, feet, or other bony areas due to the formation of cysts (an •
.abnormal sac-like growth) in bones
.Kidney stone formation •
Enlarged liver. •
Development of abnormal or missed heart beats (arrhythmias), inflammation of the •
.covering of the heart (pericarditis), or heart failure
Nervous system effects, including hearing loss, meningitis, seizures, or psychiatric •
.disorders (for example, dementia, depression, psychosis)

* In some people, symptoms may begin suddenly and/or severely and subside in a short period of
time. Others may have no outward symptoms at all even though organs are affected. Still others
.may have symptoms that appear slowly and subtly, but which last or recur over a long time span

(4)
DIAGNOSIS


There is no single way to diagnose sarcoidosis, since all the symptoms and laboratory
results can occur in other diseases. For this reason, your doctor will carefully review your
medical history and examine you to determine if you have sarcoidosis. The main tools your
:doctor will use to diagnose sarcoidosis include
Chest X-rays to look for cloudiness (pulmonary infiltrates) or swollen lymph •
.nodes (lymphadenopathy)

HRCT scan (high resolution CT) to provide an even more detailed look at the •
.lungs and lymph nodes than provided by a chest X-ray

.Pulmonary function (breathing) tests to measure how well the lungs are working •
Bronchoscopy to inspect the bronchial tubes and to extract a biopsy (a small •
tissue sample) to look for granulomas and to obtain material to rule out infection.
Bronchoscopy involves passing a small tube (bronchoscope) down
.the trachea (windpipe) and into the bronchial tubes (airways) of the lungs


TREATMENT (5)
There is no cure for sarcoidosis, but the disease may get better on its own over time. Many
people with sarcoidosis have mild symptoms and do not require any treatment. Treatment,
when it is needed, is given to reduce symptoms and to maintain the proper working order of the
affected organs.
Treatments generally fall into two categories -- maintenance of good health practices and drug
:treatment. Good health practices include
Getting regular check-ups with your healthcare provider •
Eating a well-balanced diet with a variety of fresh fruits and vegetables •
Drinking enough fluids every day •
Getting six to eight hours of sleep each night •
Exercising regularly and managing your weight •
Quitting smoking •
* Drug treatments are used to relieve symptoms and reduce the inflammation of the affected •
tissues. The oral corticosteroid prednisone is the most commonly used treatment. Fatigue and
.persistent cough are usually improved with steroid treatment
If steroids are prescribed, you should see your doctor at regular intervals so that he or she can
monitor the disease and the side effects of treatment. Other treatment options
include methotrexate(Otrexup, Rheumatrex), hydroxychloroquine (Plaquenil), and other drugs
* In many people with sarcoidosis, the disease appears briefly and then disappears without the •
person even knowing they have the disease. Twenty percent to 30% of people have some
permanent lung damage. For a small number of people, sarcoidosis is a chronic condition. In some
people, the disease may result in the deterioration of the affected organ. Rarely, sarcoidosis can be
.fatal. Death usually is the result of complications with the lungs, heart, or brain

References