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Sarcoidosis - Causes, Symptoms and Treatment


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Sarcoidosis (sar"koi-do'sis) involves inflammation that produces tiny lumps of cells in various organs in your body. The disease can attack any organ of the body in any location. Symptoms can occasionally appear suddenly but more often than not appear gradually. When viewing X-rays of the lungs , sarcoidosis can have the appearance of tuberculosis or lymphoma. The disease can appear suddenly and disappear. Or it can develop gradually and go on to produce symptoms that come and go, sometimes for a lifetime. The etiology of sarcoidosis is unknown, but several immune aberrations have been noted and are thought to play a role in its pathogenesis. Emergency medicine physicians may diagnose this disease de novo or treat its exacerbations, recurrences, and/or complications. Sarcoidosis is also characterized by distinctive laboratory abnormalities, including hyperglobulinemia, an elevated serum angiotensin converting enzyme level, evidence of depressed cellular immunity manifested by cutaneous anergy and, occasionally, hypercalcemia and hypercalciuria. It is generally a chronic disease, lasting for several years or a lifetime. Some people, however, may have a type that only lasts a few months.

Sarcoidosis usually starts in the lungs or lymph nodes in the chest. Sarcoidosis is an inflammatory disease without a known cause and without a cure. Medications that increase the Th1 response, such as interferon, have been reported to trigger or exacerbate sarcoidosis. Pulmonary sarcoidosis can cause loss of lung volume (the amount of air the lungs can hold) and abnormal lung stiffness. The most common presenting findings are thoracic lymphadenopathy, lung parenchymal abnormality, and lesions of the skin and eye. Sarcoidosis does occur in children and elderly, but most patients present between ages 20-40 years. There are many theories about the cause of sarcoidosis, including environmental exposure, a genetic (inherited) tendency to develop sarcoidosis, viral infection, immune system overactivity, or a combination of these factors. Glucocorticoids remain the mainstay of therapy when treatment is required, although other anti-inflammatory agents are being used increasingly often. Once considered a rare disease, sarcoidosis is now the most common of the fibrotic lung disorders. Treatment is based on an individual's symptoms and the degree to which involved organs are affected.

Causes of Sarcoidosis

The comman causes of Sarcoidosis include the following:

  • No one yet knows what causes sarcoidosis, some physicians believe that sarcoidosis may result from a respiratory infection caused by a virus.
  • An unidentified toxic substance.
  • Noninfectious agents, such as aluminum, zirconium, talc, pine tree pollen, and clay, have also been implicated.
  • An inherited or genetic factor.
  • A defect in body immune system.
  • Genetic as well as environmental factors are thought to play a role in the disease process.
  • Possible causes include a hypersensitive response to some factor in the environment, a genetic predisposition, or an extreme immune response to infection.

Symptoms of Sarcoidosis

Some sign and symptoms related to Sarcoidosis are as follows:

  • Fatigue, fever, headache and chills and night sweats may be the first indications of a problem in about one third of people.
  • Soreness of the eyes, and pain and swelling of the ankles.
  • Shortness of breath.
  • Lack of energy.
  • A feeling of illness (malaise).
  • Mild chest pain.
  • Enlarged lymph glands ( armpit lump ).
  • Loss of apetite.
  • A dry hacking cough or skin lesions.
  • Aches and pains.
  • vague chest pain.
  • Weight loss, and aching joints.

Treatment of Sarcoidosis

Here is list of the methods for treating Sarcoidosis:

  • Sarcoidosis symptoms often gradually resolve on their own without treatment.
  • Severely affected patients may require treatment with corticosteroids.
  • Immunosuppressive agents, such as methotrexate, azathioprine, and cyclophosphamide, are sometimes used in addition to corticosteroids.
  • Physical therapy.
  • Doctors generally recommend corticosteroid therapy as first-line therapy for individuals with the condition.
  • If prednisone fails to improve symptoms, other immune-modifying agents such as methotrexate, azathioprine, ciclosporin , hydroxychloroquine or chlorambucil may be used.
  • Topical corticosteroids may be useful in some cases of dermatologic and ocular disease.