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Sarcoidosis

Sarcoidosis is an uncommon autoimmune disorder of unknown cause that primarily affects younger individuals. The disease is characterised by the presence of non-caseating granulomas which can appear almost anywhere in the body but usually appear in the lungs. Sarcoidosis can sometimes have the appearance of tuberculosis.

Sarcoidosis is a restrictive disease of the lungs, causing a decrease in lung volume and decreased compliance (the ability to stretch). The vital capacity (full breath in, to full breath out) is decreased, and most of this air can be blown out in the first second. This means the FEV1/FVC ratio is increased from the normal of about 80%, to 90%.

Symptoms of sarcoidosis

Sarcoidosis is more commonly seen in blacks than whites. Pulmonary (lung) involvement is the most common presentation of sarcoidosis.

One-half of patients with sarcoidosis are asymptomatic. These patients are usually discovered because of an abnormal "routine" chest x-ray. In symptomatic patients, sarcoidosis can involve one or more body systems and present with a wide variety of signs and symptoms which can be constitutional; fatigue, weight loss, fever and malaise; generalized; or focused on a single organ. The onset of the disease is usually insidious but can be acute.

Respiratory symptoms are most common and include:

  • cough
  • chest discomfort
  • dyspnea

Other symptoms and signs reflect the specific organs involved by the granulomatous disease. After the thorax, the lymph nodes, skin and the eye are most often involved. Other organs much less often produce signs and symptoms despite the fact that there are granulomas on histologic examination in many organs in the majority of patients.

Treatment of sarcoidosis

Treatment is slightly controversial: the usefulness of corticosteroids in mild disease has been the subject of mounting doubt. Severe disease might need treatment with steroids, and later with steroid-sparing agents.

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