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Exam Cram
Exam Cram
Sarcoidosis is an inflammatory condition, where the body forms granulomas post infection/ cancer treatment
Presentation: dry cough, lethargy, bi-hilar lymphadenopathy on CXR; post TB/ chemo
Diagnosis: biopsy or HRCT
Management: 50% self resolving; 50% require steroids
Outline
Outline
Background
Background
Sarcoidosis is an inflammatory condition that arises when the body's immune system forms granulomas around previous sites of pathology
Sarcoidosis affects predominantly the lung (90%) and the skin (30%)
Assessment
Assessment
History:
50% asymptomatic
Sob, dry cough, tiredness, weight loss
Post chemo for lymphoma or TB clearance
Examination:
Bilateral crackles
Investigations
CXR- bilateral hilar lymphadenopathy
Raised CRP
Raised serum ACE (not sensitive or specific)
Biopsy: granulomas- asteroid bodies, nil necrosis/ caseation
Pulmonary function tests: restrictive
Diagnosis
Diagnosis
Diagnostic criteria (not standardised):
Compatible clinical presentation
Non-caseating granuloma on histopathology
Exclusion of differentials
Differentials
Tuberculosis - has necrotic lymphadenopathy
Classification: based upon site affected
Management
Management
Nothing- if not causing an issue
Prednisolone
Azathiopine
Med Reg Notes
Med Reg Notes
Managing Sarcoidosis induced hypercalcaemia.
Manage as per hypercalcaemia page
< 3mmol: nil intervention
3-3.5: usually IVF
> 3.5: 4-6L IVF/ 24hrs, if not corrected bisphosphonates
When to start steroids?
When the benefit of steroids outweighs the downsides
Significant chest symptoms
Neurosarcoidosis
Presentation: sarcoid features + seizures, confusion
MRI- multiple parenchymal nodules & white matter lesions
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