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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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