Friday, February 22, 2013

Sarcoidosis In Depth

Sarcoidosis is a disease in which inflammation occurs in the lymph nodes, lungs, liver, eyes, skin, and other tissues.  The cause of the disease is unknown.  In sarcoidosis, tiny clumps of abnormal tissue (granulomas) form in certain organs of the body.  Granulomas are clusters of immune cells.  The disease can affect almost any organ of the body, but most commonly affects the lungs.  Possible causes of sarcoidosis include:

  • Extreme immune response to infection
  • High sensitivity to environmental factors
  • Genetic factors

The disease is more common in African-Americans than in Caucasians, especially Caucasians of Scandinavian heritage.  Females are usually affected more than males.  The disease typically begins between age 20 to 40.  This condition is very rare in young children.  Someone with a close blood relative with the disease is nearly 5 times more likely to develop it.  There may be no symptoms.  When symptoms occur, they can involve any body part or organ system in the body.  Almost all patients have lung or chest symptoms: 

  • Chest pain (often behind the breast bone)
  • Dry cough 
  • Shortness of breath

Other Symptoms Include: 
  • Fatigue (one of the most common symptoms in children)
  • Fever
  • Joint achiness or pain (arthralgia)
  • Overall feeling of discomfort, illness, or lack of well-being
  • Weight loss (one of the most common symptoms in children)
  • Hair loss
  • Raised, red, firm skin sores (erythema nodosum), almost always on the front part of the lower legs
  • Rash
  • Scars that become raised or inflamed
  • Headache
  • Seizures
  • Weakness of one side of the face
  • Burning of the eyes
  • Discharge from the eye
  • Dry eyes
  • Itchy eyes
  • Eye pain
  • Vision loss
  • Dry mouth
  • Fainting spells (if the heart is involved)
  • Nosebleed
  • Swelling in the upper part of the abdomen

A physical exam may show the following: 
  • Abnormal breath sounds (such as rales)
  • Enlarged liver
  • Enlarged lymph glands
  • Enlarged spleen
  • Rash

Often the disease is found in patients with visible physical signs that have an abnormal chest x-ray.  Different imaging can be done to diagnose the disease, such as:

  • Chest x-ray (to see if the lungs are involved or the lymph glands are enlarged)
  • CT scan of the chest
  • Lung gallium scan

A biopsy is done to diagnose, normally this is done through bronchoscopy.  Biopsies of other tissues may be done as well.  The disease may affect the results of the following lab tests:

  • Calcium levels (urine, ionized, serum)
  • CBC
  • Immunoelectrophoresis - serum
  • Liver function tests
  • Quantitative immunoglobulins (nephelometry)
  • Serum phosphorus

If you have these symptoms, please get medical attention.  Stay Informed! 

 For more information about Sarcoidosis

1 comment:

  1. Serum phosphorus? Wow. What would explain that? I notice that, just as my doctor said, ACE inhibitor level dropped off the list. Being dizygous for the gene that is predictive of hypertension is still a lock.