Condition Info - BotMed Application

ConditionName

Sarcoidosis

ConditionDescription

Inflammatory disorder resulting in noncaseating granulomas in one or more organs and tissues; etiology is unknown.

Symptoms

Tender reddish bumps or patches on the skin;
Red and teary eyes or blurred vision – 25%;
Swollen and painful joints;
Hoarse voice;

Erythema nodosum – 25%;
Fever;
Fatigue;
Not productive cough;
Dyspnea;
Malaise;
Weigh loss; 

CNS involvement
Chest pain;

PhysicalFindings

Parotid gland enlargement;
Cranial nerve palsies;
Enlarged and tender lymph glands in the neck, armpits, and groin.
Enlarged lymph glands in the chest and around the lungs.
Fine rales, no wheezing.

ClinicalTests

Best initial test: xRay: bilateral hilar adenopathy , pulmonary infiltrates on xRay (ground glass appearance) 

Biopsy;
Exclusion of other granulomatous disorders;
Hilar adenopathy bilateral on xRay
ECG: Heart block and restrictive cardiomyopathy;
 AV heart block – not common, but deadly 

Most accurate test: biopsy of lymph node (involved) : noncaseating granulomas

B/c granulomas and sarcoidosis make vitamin D: 
Hypercalciuria 20% -> nephrolithiasis 
Hypercalcemia: 5%
↑serum ACE: 60% - do not use it for diagnosis! Not specific and not sensitive;
↑Alp phos;
↓WBC;
↑ESR;

PFTs: restrictive lung dx;
Decreased FEV1, FEC, TLC with normal FEV1/FVC ratio;

RiskFactors

African American;
Female;
Before 40 y/o;

IsRedFlag

IsNPLEX

Consequence

Vision loss;

ProgressionFromCondition

TreatmentOptions

Asymptomatic pts do not need treatment if they have only hilar adenopathy;
Self-resolving (80% improve without treatment);

PharmOptions

Prednisone;

WebLink

https://www.merckmanuals.com/professional/pulmonary-disorders/sarcoidosis/sarcoidosis