Sarcoidosis | |
---|---|
Other names | Sarcoïdosis, sarcoid, Besnier-Boeck-Schaumann disease[1] |
![]() | |
Chest X-ray showing the typical nodularity of sarcoidosis, predominantly in the bases of the lungs. | |
Pronunciation |
|
Specialty | Rheumatology |
Symptoms | Depends on the organ involved[2] Lungs: wheezing, cough, shortness of breath, chest pain[3] Skin: lumps, ulcers, discolored skin[3] Children: weight loss, bone pain, feeling tired[3] |
Usual onset | 20–50 year old women[4] |
Duration | Few years to long term[2][5] |
Causes | Unknown[2] |
Risk factors | Family history[4] |
Diagnostic method | Based on symptoms and tissue biopsy[6] |
Differential diagnosis | Tuberculosis, lymphoma, infectious mononucleosis, pulmonary eosinophilia[7] |
Treatment | Ibuprofen, prednisone, methotrexate[8][9] |
Prognosis | Mortality 1–7%[5] |
Frequency | 1.9 million with interstitial lung disease (2015)[10] |
Deaths | 122,000 with interstitial lung disease (2015)[11] |
Sarcoidosis is a disease involving abnormal collections of inflammatory cells that form lumps known as granulomas.[2] The disease usually begins in the lungs, skin, or lymph nodes.[2] Less commonly affected are the eyes, liver, heart, and brain.[2] Any organ, however, can be affected.[2] The signs and symptoms depend on the organ involved.[2] Often, none, or only mild, symptoms are seen.[2] When it affects the lungs, wheezing, coughing, shortness of breath, or chest pain may occur.[3] Some may have Löfgren syndrome with fever, large lymph nodes, arthritis, and a rash known as erythema nodosum.[2]
The cause of sarcoidosis is unknown.[2] Some believe it may be due to an immune reaction to a trigger such as an infection or chemicals in those who are genetically predisposed.[12][13] Those with affected family members are at greater risk.[4] Diagnosis is partly based on signs and symptoms, which may be supported by biopsy.[6] Findings that make it likely include large lymph nodes at the root of the lung on both sides, high blood calcium with a normal parathyroid hormone level, or elevated levels of angiotensin-converting enzyme in the blood.[6] The diagnosis should only be made after excluding other possible causes of similar symptoms such as tuberculosis.[6]
Sarcoidosis may resolve without any treatment within a few years.[2][5] However, some people may have long-term or severe disease.[5] Some symptoms may be improved with the use of anti-inflammatory drugs such as ibuprofen.[8] In cases where the condition causes significant health problems, steroids such as prednisone are indicated.[9] Medications such as methotrexate, chloroquine, or azathioprine may occasionally be used in an effort to decrease the side effects of steroids.[9] The risk of death is 1–7%.[5] The chance of the disease returning in someone who has had it previously is less than 5%.[2]
In 2015, pulmonary sarcoidosis and interstitial lung disease affected 1.9 million people globally and they resulted in 122,000 deaths.[10][11] It is most common in Scandinavians, but occurs in all parts of the world.[14] In the United States, risk is greater among Black people as opposed to white people.[14] It usually begins between the ages of 20 and 50.[4] It occurs more often in women than men.[4] Sarcoidosis was first described in 1877 by the English doctor Jonathan Hutchinson as a nonpainful skin disease.[15]
References edit
- ^ Konstantinidis, G. (2005). Elsevier's Dictionary of Medicine and Biology: in English, Greek, German, Italian and Latin. Elsevier. p. 1454. ISBN 978-0-08-046012-3. Archived from the original on 2020-04-16. Retrieved 2017-10-17.
- ^ a b c d e f g h i j k l m "What Is Sarcoidosis?". NHLBI. June 14, 2013. Archived from the original on 6 April 2016. Retrieved 28 March 2016.
- ^ a b c d "What Are the Signs and Symptoms of Sarcoidosis?". NHLBI. June 14, 2013. Archived from the original on 7 April 2016. Retrieved 29 March 2016.
- ^ a b c d e "Who Is at Risk for Sarcoidosis?". NHLBI. June 14, 2013. Archived from the original on 7 April 2016. Retrieved 28 March 2016.
- ^ a b c d e Wijsenbeek MS, Culver DA (December 2015). "Treatment of Sarcoidosis". Clinics in Chest Medicine. 36 (4): 751–67. doi:10.1016/j.ccm.2015.08.015. PMID 26593147.
- ^ a b c d Govender P, Berman JS (December 2015). "The Diagnosis of Sarcoidosis". Clinics in Chest Medicine. 36 (4): 585–602. doi:10.1016/j.ccm.2015.08.003. PMID 26593135.
- ^ Ferri, Fred F. (2010). Ferri's differential diagnosis: a practical guide to the differential diagnosis of symptoms, signs, and clinical disorders (2nd ed.). Philadelphia, PA: Elsevier/Mosby. p. Chapter S. ISBN 978-0-323-07699-9.
- ^ a b Drent M, Cremers JP, Jansen TL (May 2014). "Pulmonology meets rheumatology in sarcoidosis: a review on the therapeutic approach". Current Opinion in Rheumatology. 26 (3): 276–84. doi:10.1097/bor.0000000000000052. PMID 24614277.
- ^ a b c Judson MA (February 2016). "Corticosteroids in Sarcoidosis". Rheumatic Diseases Clinics of North America. 42 (1): 119–35, ix. doi:10.1016/j.rdc.2015.08.012. PMID 26611555.
- ^ a b GBD 2015 Disease Injury Incidence Prevalence Collaborators (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
{{cite journal}}
:|author1=
has generic name (help)CS1 maint: numeric names: authors list (link) - ^ a b GBD 2015 Mortality Causes of Death Collaborators (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/S0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
{{cite journal}}
:|author1=
has generic name (help)CS1 maint: numeric names: authors list (link) - ^ Baughman RP, Culver DA, Judson MA (March 2011). "A concise review of pulmonary sarcoidosis". American Journal of Respiratory and Critical Care Medicine. 183 (5): 573–81. doi:10.1164/rccm.201006-0865CI. PMC 3081278. PMID 21037016.
- ^ "What Causes Sarcoidosis?". NHLBI. June 14, 2013. Archived from the original on 6 April 2016. Retrieved 28 March 2016.
- ^ a b Kobak S (October 2015). "Sarcoidosis: a rheumatologist's perspective". Therapeutic Advances in Musculoskeletal Disease. 7 (5): 196–205. doi:10.1177/1759720x15591310. PMC 4572362. PMID 26425148.
- ^ James DG, Sharma OP (September 2002). "From Hutchinson to now: a historical glimpse" (PDF). Current Opinion in Pulmonary Medicine. 8 (5): 416–23. doi:10.1097/00063198-200209000-00013. PMID 12172446. Archived (PDF) from the original on 2016-03-04.