FactsDr.Wafaa El Metwaly

APRIL 1, 2015

Differential Diagnosis of Granulomatous Lung

Disease

What is Sarcoidosis ?

Causes

Affected Areas

Stages of Pulmonary Sarcoidosis

Symptoms of Sarcoidosis

Treatment

What is it ?

An immune reaction to an infection or some other trigger

(called an Antigen, which may be from one's environment)

that continues even after the initial infection or other

antigen is cleared from the body.

In most cases it clears up by itself without any medical

intervention, but some cases go on to affect the person long-

term or become life-threatening.

The exact cause of Sarcoidosis is

unknown. However, possible causes and

risk factors include:

Having a prior infection

Having a sensitivity to environmental

factors, such as dust

Being African-American

Being a Female

Having a family history of Sarcoidosis

Areas of the body commonly affected by Sarcoidosis include:

Lymph Nodes

Lungs

Eyes

Skin

Liver

Heart

Brain

Bihilar Lymphadenopathy

Pulmonary Sarcoidosis

Cutaneous Sarcoidosis

Ocular Sarcoidosis

Hepatic Sarcoidosis

Heart Sarcoidosis

Stage 1: Bihilar Lymphadenopathy

Stage 2: Bihilar Lymphadenopathy and

Reticulonodular Infiltrates

Stage 3: Bilateral Pulmonary Infiltrates

Stage 4: Fibrocystic Sarcoidosis Typically with

Upward Hilar Retraction, Cystic and Bullous

Changes

General Symptoms May Include:

Fatigue

Fever

Weight Loss

Chronic Joint Pain

Dry Mouth

Nasal Bleeding

Abdominal Swelling

Lung Symptoms May Include:

A Dry Cough

Shortness of Breath

Chest Pain

Skin Symptoms may include:

Skin Rash

Skin Sores

Hair Loss

Raised Scars

Nervous System Symptoms May Include:

Seizures

Facial Weakness

Headaches

Eye Symptoms may include:

Dry Eyes

Itchy Eyes

Vision Loss

Burning Sensation

Eye Discharge

1. Chest X-Rays: This test provides a picture of

the lungs, heart and surrounding lymph nodes,

2. Biopsy: A definitive diagnosis requires a biopsy

of non-necrotizing granulomas.

3. CT Scan

4. Purified Protein Derivative

5. Slit-Lamp Examination

6. Blood Tests

About 60 to 80 percent of Sarcoidosis cases are

self-limiting, meaning that they disappear, at

least partially, without intervention, usually

within 2 to 3 years

Most persons only require symptomatic

treatment with non-steroidal anti-inflammatory

drugs (NSAIDs) like ibuprofen or aspirin

Corticosteroids, most commonly prednisone or

prednisolone

Severe symptoms are generally treated with

corticosteroids although steroid-sparing agents

such as methotrexate.

Immunosuppressants

Cutaneous disease may be successfully managed

with antimalarials (such as Chloroquine)

Colchicine