Sarcoidosis - Causes, Symptoms and Treatment

Sarcoidosis is an immune system disorder characterised by non- caseating granulomas (small inflammatory nodules). The disease most commonly involves granuloma formation in the lungs. Pulmonary sarcoidosis can cause loss of lung volume (the amount of air the lungs can hold) and abnormal lung stiffness Other commonly involved organ systems include the lymph nodes (especially the intrathoracic nodes); the skin; the eyes; the liver; the heart; and the nervous, musculoskeletal, renal, and endocrine systems. The disease is characterized by the presence of granulomas, small areas of inflamed cells. They can be either inside the body or on the body's exterior, appearing as sores on the face or shins. But sarcoidosis is most frequently found in the lungs. Sarcoidosis affects people worldwide. It is found in every country and every race, although the incidence varies dramatically. In Europe, the disease affects whites more commonly than other races, and it affects Western Europeans more than Eastern Europeans. Pulmonary involvement is the most common presentation of sarcoidosis An increase in B-cell activity with hypergammaglobulinemia noted in about one half of patients and in nonspecific immune-complex formation. Reduced delayed-type hypersensitivity responses are also found in many patients with sarcoidosis. Cutaneous anergy to tuberculin intradermal testing occurs in two thirds of patients. Immune dysregulation has been theorized to be due to a persistent antigen of low virulence that is poorly cleared by the immune system, leading to a chronic T cell of the Th1 subtype response, which results in granuloma formation. Recently, the gli -1 oncogene has been found to be highly expressed in persons with granulomatous skin diseases, including sarcoidosis. Sarcoidosis is a systemic disease that can affect any organ.

Sarcoidosis may result from a respiratory infection caused by a virus. Others suspect that exposure to toxins or allergens in the environment is to blame. Sarcoidosis frequently causes a dysregulation of vitamin D production with an increase in extrarenal (outside the kidney) production. Specifically, macrophages inside the granulomas convert vitamin D to its active form, resulting in elevated levels of the hormone. Physiological compensatory responses (e.g. suppression of the parathyroid hormone levels) may mean the patient does not develop frank hypercalcemia. Combination of erythema nodosum, bilateral hilar lymphadenopathy and arthralgia is called Lofgren syndrome. Common symptoms are vague, such as fatigue unchanged by sleep, lack of energy , weight loss , aches and pains, arthralgia , dry eyes , blurry vision, shortness of breath , a dry hacking cough or skin lesions. The cutaneous symptoms vary, and range from rashes and noduli (small bumps) to erythema nodosum or lupus pernio.Renal, liver (including portal hypertension ), heart or brain involvement may cause further symptoms and altered functioning. Manifestations in the eye include uveitis and retinal inflammation, which may result in loss of visual acuity or blindness. Sarcoidosis affecting the brain or nerves is known as neurosarcoidosis. Sarcoidosis is mainly a disease of young adults -- patients between the ages of 20 and 40 -- although a few persons past 60 have been known to contract it. Corticosteroids , most commonly prednisone , have been the standard treatment for many years. steroid-sparing agents such as azathioprine and methotrexate are often used. Avoidance of sunlight and Vitamin D foods may be helpful in patients who are prone to developing hypercalcemia.

Causes of Sarcoidosis

Common Causes and Risk factors of Sarcoidosis

Environmental influence
Genetic factors.
Viral/bacterial infection
A defect in body immune system
An unidentified toxic substance

Sign and Symptoms of Sarcoidosis

Common Sign and Symptoms of Sarcoidosis

Shortness of breath
Cough
Skin rashes.
Chest pain
Weight loss
Fatigue
Night sweats
Fever.
Wheezing.

Treatment for Sarcoidosis

Common Treatment for Sarcoidosis

Corticosteroids most commonly prednisone , have been the standard treatment for many years. Use of corticosteroids in mild disease is controversial because in many cases the disease remits spontaneously.
Steroids, and steroid-sparing agents such as azathioprine and methotrexate are often used. Rarely, cyclophosphamide has also been used.
Some early indications of success using immunosuppressants, interleukin-2 inhibitors or anti- tumor necrosis factor-alpha treatment (such as infliximab ).
Avoidance of sunlight and Vitamin D foods may be helpful in patients who are prone to developing hypercalcemia.
Radiation has also been used to treat treatment-resistant cutaneous lesions.
Surgery is also efective treatmen of Sarcoidosis.

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