Sarcoidosis
Respiratory (12%) Core Clinical Conditions
2B The Physician Associate is able to undertake the day to day management of the patient and condition once the diagnosis and strategic management decisions have been made by another.
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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management
Definition
Sarcoidosis is a chronic disease where there is an increase in the number of granulomas ( a small group of white blood cells + other tissue ). These granulomas can gather in several organs: eyes, lymph nodes, skin, lungs, and liver. These cells can impair the normal function of several organs.
Aetiology
Unknown causes, however could be:
Genetic predisposition.
Environmental causes.
Exposure to some infections or chemicals.
Abnormal immune response.
Pathophysiology
Exposure to unknown antigen > immune response, however there is an overactive immune response > formation of granulomas.
Risk factors
Family history of sarcoidosis.
Ethnicity: Scandinavian or Africans are more at risk.
Exposure to certain environmental factors or occupations.
Sign and symptoms
Visual disturbances.
Coughing (persistent).
Shortness of breath.
Chest pain or discomfort.
Skin rashes or lesions.
Joint ache/pain.
Diagnosis and investigations
Good history and physical exam: check eyes, skin, joints and occupation.
Chest x-ray: bilateral hilar lymphadenopathy (BHL) is a common finding.
Blood test: full blood count (FBC), liver function test (LFT), electrolytes (UE). Note hypercalcaemia is a common finding.
ECG: arrhythmia may trigger further investigations.
CT scan.
Sputum sample: generally requested if there is suspicion of tuberculosis (TB).
Management
90% patients don't require treatment as spontaneous remission occurs.
Medication treatment: simple analgesia such as paracetamol or NSAIDs, immunosuppressants and/or corticosteroids.
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