Sarcoidosis

Sarcoidosis

It is a systemic granulomatous disease, which is characteristic of the formation of small, noncaseating granulomas (lumps in appearance). This applies mainly young people (peak incidence between 20 and 29 years of age), slightly more often affects women. The most common symptoms are changes in the performance of X-ray - lymphadenopathy and cavities in the lung parenchyma changes. It can involve every organ. Pathogenesis has not yet been clarified, the current theories suggest an infectious cause (a bacterium is not detectable in standard diagnostic tests), hypervitaminosis D of unknown cause, genetic causes.

Diagnosis

Clinical symptoms, radiological changes (the seizure of two or more organs) and positive biopsies of bronchial mucosa / lung / lymph nodes. The most valuable diagnostic tests are computed tomography and bronchoscopy.

Types

The disease is systemic disease, but we can distinguish several specific types:

a) systemic sarcoidosis (occupied different organs, the symptoms depend on location, can be distinguished from nonspecific drowsiness, fatigue, dry eyes, vision problems, cough, skin involvement);

b) sarcoidosis dermal (with the presence of systemic symptoms or without them):

• nodular sarcoid (Darier-Roussy) - tumors (without signs of inflammation), mainly on the lower limbs;

• variety of vascular (angiolupoid) - place affected is the skin of the nose, which are bluish - brown or reddish nodules;

• lupus pernio - after exposure to cold, appears as a bluish - red infiltration, usually on the face and hands;

• diffuse micronodular variant (sarcoidosis miliaris);

• micronodular variant (sarcoidosis circinata);

• Lofgren syndrome (a combination of nodular sarcoid lymphadenopathy nodular erythema and arthralgia).

Symptoms: shortness of breath, chest pain, aching joints and muscles, enlarged, mobile and painless lymph nodes, hepatomegaly, conjunctivitis, iris and eye inflammation, facial palsy, symptoms of skin, cardiac arrhythmia, enlargement of the parotid gland, loss of appetite, weight loss, increased body temperature.

Treatment

Indications for treatment are advanced stage disease, heart, CNS, eye insufficiency, hypercalcemia. Medications: oral corticosteroids, methotrexate, cyclophosphamide, treatment of coexisting symptoms (e.g. pulmonary hypertension).