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  Sarcoidosis

Sarcoidosis is a disease that affects the skin and internal organs. Lumps of fibrous tissues called granulomas develop on the skin and organs. Granulomas are small masses of granulation tissue that are caused by chronic infection. Granulation describes the type of tissue that forms over healing wounds.

Sarcoidosis Lung diseases
Sarcoidosis


This disease is also known as sarcoid or Besnier-Boeck disease. Sarcoidosis is an immune system condition. Any organ can be affected by the granulomas, but mostly the lungs and the lymph nodes are attacked. An X-ray of the lungs often looks like tuberculosis or lymphoma.

Symptoms:

Symptoms for Sarcoidosis are fatigue even with good sleeping pattersn, malaise, joint pain, generalized aches and pains, blurry vision, dry eyes, shortness of breath, skin lesions or rashes and a dry hacking cough. Skin symptoms vary and can change from small bumps and rashes to erythena nodosum or lupus pernio. Erythema nodosum are inflamed fat cells that present as sore red nodules on both shins of the legs. Erythema nodosum is a symptomatic condition of Sarcoidosis and other immune disorders. Lupus pernio is also a symptomatic condition of Sarcoidosis and presents as a chronic hard lesions of the skin that are purple and raised. Lupus pernio resembles frostbite because it usually appears on the extremities such as the ears, cheeks, lips, fingers, forehead, hands and nose. Other symptoms are present when the heart, brain, kidneys or liver are affected. Sarcoidosis that affects the nervous system and brain is referred to as neurosarcoidosis. Sarcoidosis affects the eyes causing retinal inflammation, and uveitis. Uveitis is an inflammation of the uvea or the center of the three layers of the eyeball, made up of the choroid, ciliary body, and iris which surround the lens.

Diagnosis:

Sarcoidosis is diagnosed by eliminating other disorders of the lungs. Disorders that Sarcoidosis mimic are chronic beryllium disease and tuberculosis.

The diagnosis is confirmed after a physical history determines that noncaseating granulomas are present and other conditions which cause granulomas are ruled out.

If a biopsy is not possible a Kyeim-Siltzback test can be performed. This test is not readily available in the United States and is used in atypical cases. Most Sarcoidosis cases affect the lungs the lymph nodes in the thorax. A chest X-ray is the most useful diagnostic tool. Initial evaluation of a suspected case involves the following tests: pulmonary function, electrocardiography, blood tests (for liver, renal and calcium), chest radiograph and an ophthalmologic evaluation. Electrocardiograms (ECGs) are used to determine if Sarcoidosis is affecting the heart.

Treatment:

Sarcoidosis can partially disappear in up to 80% of patients without any treatment or intervention within 2 to 3 years of diagnosis. More often than not, the patient never knew they had the disease. Unfortunately, up to 30% of patients suffer a small number of permanently damaged tissues, generally in the lungs. If sarcoidosis does not clear up on its own, it either stabilizes or progresses to a more severe form. There is a 1 in 5 chance that sarcoidosis patients can be permanently debilitated by the disease. This disease is life threatening in up to 10% of diagnosed patients.

Prednisone and other corticosteroids are the standard medication for sarcoidosis. Unfortunately, some patients do not respond to steroid therapy. Other patients may experience a reversal of the disease or a slower progression. Steroids have been linked to causing relapses and progression of the disease.

Immuno-suppressants have been used as treatments for sarcoidosis with some success in drug trials. Another drug, known as anti-tumor necrosis factor has also been used. The most dangerous side affect is an increased susceptibility to latent tuberculosis. These treatments have yet to be proven reliable.

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