SARCOIDOSIS
Facts and Information
Disease Description:
Sarcoidosis is a granulomatous
disease that will mainly affect lymphatic and lung systems.
The disease was first identified in 1877 by Jonathan Hutchinson, a dermatologist
at Kings' College in London of the U.K. Sarcoidosis can affect people
of all ethnicity's and origins. The disease is the most common fibrotic
lung disorder in the United States. Sarcoidosis is also very common
in Scandinavian countries, U.K., Japan and Ireland; while appearing less
in China, Korea, India, Asia, Africa and Central and South America.
The disease is a 12:1 black to white ratio. It affects 2:1 men than
women amongst black people while affecting men and women equally among
whites. Sarcoidosis can affect any organ in the body, but is usually
involved with the lungs, liver, spleen, skin, eyes, myocardium (heart),
central nervous system (CNS) and the bones and joints of the body (Foundation
for Sarcoidosis Research, 1-2).
Cause and Etiology:
The cause of Sarcoidosis is unknown.
The disease has not shown any specific factors that could be linked to
the cause. Early studies and tests were performed on environmental
agents such as soils, plants, pine pollen and farm animals to see if there
was any connection between them, but all came up negative. The disease
is most likely due to an inflammatory response to such things as bacteria,
viruses, chemicals and fungi. Predisposition is believed to be a
key factor also ( Foundation for Sarcoidosis research, 2-3).
Signs and Symptoms:
Many Sarcoidosis patients have no symptoms regarding pulmonary Sarcoidosis.
Patients may experience dry cough, shortness of breath, chest pain, fatigue,
weakness and weight loss. Sarcoidosis outside of the lungs can be
accompanied by red bumps of the legs, sore eyes, fever and pain and swelling
of the ankles. Ninety percent of Sarcoidosis occur in the lungs but
the other ten percent are related to the skin, liver, lymph glands, spleen,
eyes, nervous system, muscle and bones, heart and the kidneys. As
mentioned before, most patients have no symptoms, the disease actually
is described as burning itself out, meaning that it will disappear without
notice. On the other hand, pulmonary Sarcoidosis can advance to pulmonary
fibrosis which can scar the lungs and interface with breathing (American
Lung Association, 2-3).
Diagnosis:
Diagnosis is not made easily. The problem is that the symptoms are
general. Other diseases can cause granulomatous markings in the lungs.
No one individual test can diagnose the disease, it is usually a combination
of several. A chest x-ray can be taken and blood work done.
Also a Pulmonary Function Test also known as a PFT can be done. Other
tests include a Bronchoalveolar lavage, lung biopsy and a Gallium scan
done in Nuclear Medicine. Symptoms must usually occur in more than
one site for proper diagnosis to be made. The disease may advance
to become more serious before it is diagnosed (Foundation for Sarcoidosis
Research, 4).
Treatment and Prognosis:
The main treatment for Sarcoidosis is Corticosteroids.
The degree of the symptoms will determine whether or not steroid therapy
will be used. The amount of symptoms that must be present in order
for steroid therapy to be used is still up for question. Early studies
proved evident that a long course of cortisone resulted in a remission
of the granulomas. The oral corticosteroid Prednisone has shown to
alleviate symptoms of pulmonary Sarcoidosis. Prednisone is also used
for cardiac Sarcoidosis and neurosarcoidosis but at higher doses.
After around 1-3 months the patient should be evaluated to see the response
of the steroids. Topical steroids are available for patients with
skin lesions. Drugs such as Chloroquine, Hydroxychloroquine, Methotrexate
and Azathioprine are used on patients who cannot tolerate steroid therapy.
In absolute severe cases, heart and lung transplant may be necessary.
In most cases prognosis is good because of the ability of Sarcoidosis to
burn it self out (Sarcoidosis Vasculitis and Diffuse Lung Disease, 1-3).
Sources
American Lung
Association (2001). Sarcoidosis. [Online]. Available:
http//www.lungusa.org/diseases/lungsarcoido.html
(2-21-01).
Foundation
for Sarcoidosis Research (2001). What Is Sarcoidosis? [Online].
Available:
http://www.fightsarcoidosis.org/content-what.htm
(2-21-01).
Sarcoidosis
Vasculitis and Diffuse Lung Disease (1999). ATS/ERS/WASOG Statement
on Sarcoidosis. [Online].
Available: http://www.pinali.unipad.it/sarcoid/intro.htm
(2-21-01).
Written by Jason R. Abbott (Radiology
Student) 
My Everyday Life!!!!
Northern Kentucky University
Department of Radiology
jrabbott34@hotmail.com
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