Sarcoidosis

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Sarcoidosis is an inflammatory disease with no known cause. It causes the body’s immune cells to clump together and form granulomas, which, over time, can cause organ damage. Symptoms vary according to the organs affected, but many complain of joint and muscle pain, enlarged lymph nodes, and difficulty breathing. Others have no symptoms.

Sarcoidosis is an inflammatory disease characterized as “…a multisystem inflammatory disease of unknown etiology…”1 As part of the immune response to harmful substances, the body releases specialized cells, which emit chemicals that isolate and kill the substance. Part of the process involves inflammation, which dissipates on its own in most people.

While sarcoidosis can strike anyone, male or female, of any age, there may be an ethnic component in risk factors for sarcoidosis. It occurs most often in people of Asian, African-American, German, Irish, Puerto Rican, and Scandinavian descent. The most common age span for onset is between 20 and 40 years old. Additionally, it is more common in African American women than in African American men. How sarcoidosis manifests often varies according to the individual’s ethnic background.

When the body produces an immune response in reaction to a harmful foreign substance, inflammation eventually goes away on its own. However, in people with sarcoidosis, inflammation persists, resulting in cells grouping together, forming granulomas. Granulomas form in various parts of the body, but most commonly in the lungs and lymph nodes. Granulomas are tiny lumps that clump together, forming larger lumps that interfere with organ function. In addition to the lungs and lymph nodes, sarcoidosis may appear in the eyes, skin, heart, and brain.

Symptoms of sarcoidosis somewhat depend upon the organs involved.

  • Some people have fever, arthritis, and enlarged and tender lymph nodes.
  • When present in the lungs, sarcoidosis may cause wheezing, coughing, pain, and shortness of breath.
  • Some suffer from a reddish rash, usually on the lower legs, called erythema nodosum.
  • The disease may bring about ulcers, sores, and discoloration on the skin, usually on the back, scalp, and extremities. They may also show up near the nose and eyes, and generally last a long time.
  • Some sarcoidosis sufferers experience fatigue, along with feelings of depression.
  • Unexplained weight loss is another symptom of the disease.
  • Enlarged liver, spleen, or salivary glands are symptoms of sarcoidosis.

Sarcoidosis may be mild or severe. Severe cases may lead to organ damage. However, many people have the disease and do not have any symptoms. In addition to a complete medical exam, diagnosing sarcoidosis often includes chest X-rays, and/or chest CTs.

While some people with sarcoidosis have organ damage, the condition is rarely fatal. The majority of people recover with no permanent problems. Those with the highest risk of long-term problems are those who suffer from chronic sarcoidosis, such as those with scarring of the lungs, who develop a specific type of lupus called lupus perneo, or those with brain and heart involvement.

Treating sarcoidosis rests upon identifying the organs involved and then prescribing appropriate treatments to reduce or eliminate inflammation, discomfort, and potential organ damage. Medscape reports that the vast majority of sarcoidosis patients require only treatment to alleviate symptoms using NSAIDs. However, immune-suppressant drugs and steroids such as prednisone are often use in treating sarcoidosis, as are inhaled medicines that alleviate breathing and coughing issues. 

Sources:

http://www.nhlbi.nih.gov/health/health-topics/topics/sarc/.

http://emedicine.medscape.com/article/301914-treatment.

http://www.nhlbi.nih.gov/health/health-topics/topics/sarc/signs.html.

http://www.nhlbi.nih.gov/health/health-topics/topics/sarc/treatment.html.

http://www.nhlbi.nih.gov/health/health-topics/topics/sarc/atrisk.html.

http://emedicine.medscape.com/article/301914-overview.

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Glossary

alveolus air sac where gas exchange takes place.
angina chest pain.
aorta blood vessel that delivers oxygen-rich blood from the left ventricle to the body; it is the largest blood vessel in the body.
apex top portion of the upper lobes of the lungs.
atrium one of the two receiving chambers of the heart.
base bottom portion of lower lobes, located just above the diaphragm.
blood pressure pressure of blood against the walls of a blood vessel or heart chamber.
bronchiolitis inflammation that involves the bronchioles (small airways).
bronchoscopy the examination of the bronchi (the main airways of the lungs) using a flexible tube (bronchoscope). Bronchoscopy helps to evaluate and diagnose lung problems, assess blockages, obtain samples of tissue and/or fluid, and/or to help remove a foreign body.
bronchus large airways; lung divides into right and left bronchi.
cardiac output total amount of blood being pumped by the heart over a particular period of time.
catheter thin, flexible medical tube; one use is to insert it into a blood vessel to measure blood pressure.
constrict tighten; narrow.
cyanosis bluish color in the skin because of insufficient oxygen.
diaphragm primary muscle used for respiration, located just below the lung bases.
diastolic pressure lowest pressure to which blood pressure falls between contractions of the ventricles.
dilate relax; expand.
dyspnea sensation of difficulty in breathing.
edema swelling due to the buildup of fluid.
endothelial cells the delicate lining, only one cell thick, of the organs of circulation.
expiration exhaling; giving off carbon dioxide.
heartbeat one complete contraction of the heart.
hyperactive describes a situation in which a body tissue is especially likely to have an exaggerated reaction to a particular situation.
hypertension abnormally high blood pressure.
hypotension abnormally low blood pressure.
inspiration inhaling; taking in oxygen.
lobectomy removal of an entire lobe of the lung.
lung volume the amount of air the lungs hold.
mean blood pressure average blood pressure, taking account of the rise and fall that occurs with each heartbeat. It is often estimated by multiplying the diastolic pressure by two, adding the systolic pressure, and then dividing this sum by three.
palpitation sensation of rapid heartbeats.
perfusion flow.
pleura membrane that covers the outside of the lung.
pneumonectomy removal of an entire lung.
pulmonary artery blood vessel delivering oxygen-poor blood from the right ventricle to the lungs.
pulmonary hypertension abnormally high blood pressure in the arteries of the lungs.
smooth muscle muscle that performs automatic tasks, such as constricting blood vessels.
spirogram record of the amounts of air being moved in and out of the lungs.
syncope fainting; temporary loss of consciousness.
systemic relating to a process that affects the body generally; in this instance, the way in which blood is supplied through the aorta to all body organs except the lungs.
systolic pressure the highest pressure to which blood pressure rises with the contraction of the ventricles.
vasodilator agent that widens blood vessels.
ventilation movement of air (gases) in and out of the lungs.
ventricle one of the two pumping chambers of the heart; right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery; left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta.