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Facts
Dr.Wafaa El Metwaly
APRIL 1, 2015
 Differential Diagnosis of Granulomatous Lung
Disease
 What is Sarcoidosis ?
 Causes
 Affected Areas
 Stages of Pulmonary Sarcoidosis
 Symptoms of Sarcoidosis
 Treatment
What is it ?
An immune reaction to an infection or some other trigger
(called an Antigen, which may be from one's environment)
that continues even after the initial infection or other
antigen is cleared from the body.
In most cases it clears up by itself without any medical
intervention, but some cases go on to affect the person long-
term or become life-threatening.
 The exact cause of Sarcoidosis is
unknown. However, possible causes and
risk factors include:
Having a prior infection
Having a sensitivity to environmental
factors, such as dust
Being African-American
Being a Female
Having a family history of Sarcoidosis
Areas of the body commonly
affected by Sarcoidosis include:
Lymph Nodes
Lungs
Eyes
Skin
Liver
Heart
Brain
Bihilar Lymphadenopathy
Pulmonary Sarcoidosis
Cutaneous Sarcoidosis
Ocular Sarcoidosis
Hepatic Sarcoidosis
 Heart Sarcoidosis
 Stage 1: Bihilar Lymphadenopathy
 Stage 2: Bihilar Lymphadenopathy and
Reticulonodular Infiltrates
 Stage 3: Bilateral Pulmonary Infiltrates
 Stage 4: Fibrocystic Sarcoidosis Typically with
Upward Hilar Retraction, Cystic and Bullous
Changes
 General Symptoms May Include:
 Fatigue
 Fever
 Weight Loss
 Chronic Joint Pain
 Dry Mouth
 Nasal Bleeding
 Abdominal Swelling
 Lung Symptoms May Include:
A Dry Cough
Shortness of Breath
Chest Pain
 Skin Symptoms may include:
 Skin Rash
 Skin Sores
 Hair Loss
 Raised Scars
 Nervous System Symptoms May Include:
 Seizures
 Facial Weakness
 Headaches
 Eye Symptoms may include:
 Dry Eyes
 Itchy Eyes
 Vision Loss
 Burning Sensation
 Eye Discharge
1. Chest X-Rays: This test provides a picture of
the lungs, heart and surrounding lymph nodes,
2. Biopsy: A definitive diagnosis requires a biopsy
of non-necrotizing granulomas.
3. CT Scan
4. Purified Protein Derivative
5. Slit-Lamp Examination
6. Blood Tests
 About 60 to 80 percent of Sarcoidosis cases are
self-limiting, meaning that they disappear, at
least partially, without intervention, usually
within 2 to 3 years
 Most persons only require symptomatic
treatment with non-steroidal anti-inflammatory
drugs (NSAIDs) like ibuprofen or aspirin
 Corticosteroids, most commonly prednisone or
prednisolone
 Severe symptoms are generally treated with
corticosteroids although steroid-sparing agents
such as methotrexate.
 Immunosuppressants
 Cutaneous disease may be successfully managed
with antimalarials (such as Chloroquine)
 Colchicine
Sarcoidosis

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Sarcoidosis

  • 2.  Differential Diagnosis of Granulomatous Lung Disease  What is Sarcoidosis ?  Causes  Affected Areas  Stages of Pulmonary Sarcoidosis  Symptoms of Sarcoidosis  Treatment
  • 3.
  • 4. What is it ? An immune reaction to an infection or some other trigger (called an Antigen, which may be from one's environment) that continues even after the initial infection or other antigen is cleared from the body. In most cases it clears up by itself without any medical intervention, but some cases go on to affect the person long- term or become life-threatening.
  • 5.  The exact cause of Sarcoidosis is unknown. However, possible causes and risk factors include: Having a prior infection Having a sensitivity to environmental factors, such as dust Being African-American Being a Female Having a family history of Sarcoidosis
  • 6. Areas of the body commonly affected by Sarcoidosis include: Lymph Nodes Lungs Eyes Skin Liver Heart Brain
  • 13.  Stage 1: Bihilar Lymphadenopathy
  • 14.  Stage 2: Bihilar Lymphadenopathy and Reticulonodular Infiltrates
  • 15.  Stage 3: Bilateral Pulmonary Infiltrates
  • 16.  Stage 4: Fibrocystic Sarcoidosis Typically with Upward Hilar Retraction, Cystic and Bullous Changes
  • 17.  General Symptoms May Include:  Fatigue  Fever  Weight Loss  Chronic Joint Pain  Dry Mouth  Nasal Bleeding  Abdominal Swelling
  • 18.  Lung Symptoms May Include: A Dry Cough Shortness of Breath Chest Pain  Skin Symptoms may include:  Skin Rash  Skin Sores  Hair Loss  Raised Scars
  • 19.  Nervous System Symptoms May Include:  Seizures  Facial Weakness  Headaches  Eye Symptoms may include:  Dry Eyes  Itchy Eyes  Vision Loss  Burning Sensation  Eye Discharge
  • 20. 1. Chest X-Rays: This test provides a picture of the lungs, heart and surrounding lymph nodes, 2. Biopsy: A definitive diagnosis requires a biopsy of non-necrotizing granulomas. 3. CT Scan 4. Purified Protein Derivative 5. Slit-Lamp Examination 6. Blood Tests
  • 21.  About 60 to 80 percent of Sarcoidosis cases are self-limiting, meaning that they disappear, at least partially, without intervention, usually within 2 to 3 years  Most persons only require symptomatic treatment with non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin  Corticosteroids, most commonly prednisone or prednisolone
  • 22.  Severe symptoms are generally treated with corticosteroids although steroid-sparing agents such as methotrexate.  Immunosuppressants  Cutaneous disease may be successfully managed with antimalarials (such as Chloroquine)  Colchicine