This document provides information on sarcoidosis, a disease characterized by the growth of granulomas in multiple organs of the body. It begins by discussing the causes of sarcoidosis, which is an immune reaction that continues even after the initial trigger is cleared. Common areas affected include the lungs, eyes, skin, and lymph nodes. The stages of pulmonary sarcoidosis and associated symptoms are described. Treatment options are outlined, ranging from symptomatic treatment for mild cases to corticosteroids and immunosuppressants for more severe symptoms.

1. Facts
Dr.Wafaa El Metwaly
APRIL 1, 2015

2.  Differential Diagnosis of Granulomatous Lung
Disease
 What is Sarcoidosis ?
 Causes
 Affected Areas
 Stages of Pulmonary Sarcoidosis
 Symptoms of Sarcoidosis
 Treatment

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

7. Bihilar Lymphadenopathy

8. Pulmonary Sarcoidosis

9. Cutaneous Sarcoidosis

10. Ocular Sarcoidosis

11. Hepatic Sarcoidosis

12.  Heart Sarcoidosis

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