Sarcoidosis

Sarcoid

• A multisystem granulomatous disorder presenting usually as
• Bilateral hilar lymphadenopathy
• Pulmonary infiltration
• Skin/eye lesions

Epidemiology

• 19 in 100000
• Female > Male
• More severe in Blacks than Whites

Aetiology

• Unknown

Clinical features

• Third or fourth decade

Extrapulmonary features

• Skin
• Erythema nodosum
• Lupus pernio
• Eye
• Uveitis 
• Conjunctivitis
• Keratoconjunctivitis sicca
• Face
• Parotitis
• Facial nerve palsy
• Metabolic
• Hypercalcaemia (10%)
• CNS
• Meningoencephalitis
• Spinal cord disease
• Myopathy
• Polyneuropathy
• Gastrointestinal
• Hepatosplenomegaly
• Cardiovascular
• Cardiomyopathy

Investigations

• Chest X-ray
• CT chest
• Blood tests
• FBC (normocytic anaemia)
• Increased ESR
• Increased Ca++
• Increased Serum angiotensin-converting enzyme (ACE)
• Transbronchial biopsy
• Spirometry
• Restrictive defect
• Decreased Gas transfer

Presentations

• Respiratory symptoms / abnormal chest X-ray
• 50%
• Fatigue or weight loss
• 5%
• Peripheral lymphadenopathy
• 5%
• Fever
• 4%
• Normal chest X-ray
• 20%