Sarcoidosis: Difference between revisions
ClaireLewis (talk | contribs) No edit summary |
No edit summary |
||
| Line 4: | Line 4: | ||
**Exact cause unknown - thought to be related to an immune reaction to a prior insult such as infection or chemical exposure earlier in life. | **Exact cause unknown - thought to be related to an immune reaction to a prior insult such as infection or chemical exposure earlier in life. | ||
**Do not confuse with infectious granulomatous processes such as [[tuberculosis]]. | **Do not confuse with infectious granulomatous processes such as [[tuberculosis]]. | ||
==Clinical Features== | ==Clinical Features== | ||
[[File:PMC3505767 ad-24-383-g009.png|thumb|Sarcoidosis. (A) Subcutaneous nodules without changes in overlying epidermis. (B) Characteristic non-caseating granuloma with giant cell.]] | |||
''Depend on location of granulomata. May be entirely asymptomatic.'' | ''Depend on location of granulomata. May be entirely asymptomatic.'' | ||
*Respiratory | *Respiratory | ||
| Line 44: | Line 43: | ||
*[[Polymyalgia rheumatica]] | *[[Polymyalgia rheumatica]] | ||
== | ==Evaluation== | ||
[[File:SarcoidXray.png|thumb|Sarcoid Xray - hilar adenopathy]] | |||
*Definitive initial diagnosis unlikely to be made in ED, but may be suggested by typical granulomatous lesions seen on CT or other imaging in setting of appropriate clinical context | *Definitive initial diagnosis unlikely to be made in ED, but may be suggested by typical granulomatous lesions seen on CT or other imaging in setting of appropriate clinical context | ||
*Evaluate for complications/alternative diagnoses of presenting symptoms | *Evaluate for complications/alternative diagnoses of presenting symptoms | ||
| Line 53: | Line 53: | ||
==Disposition== | ==Disposition== | ||
* | *Dependent on presentation | ||
==See Also== | ==See Also== | ||
Revision as of 16:58, 9 September 2020
Background
- Abnormal collection of inflammatory cells (granulomas) throughout the body.
- Most common location for granulomas to occur are the lung, skin, heart, and brain.
- Exact cause unknown - thought to be related to an immune reaction to a prior insult such as infection or chemical exposure earlier in life.
- Do not confuse with infectious granulomatous processes such as tuberculosis.
Clinical Features
Depend on location of granulomata. May be entirely asymptomatic.
- Respiratory
- Due to pulmonary granulomata
- Shortness of breath
- Cough
- Pulmonary hypertension
- Pulmonary abscesses/empyema
- Pneumothorax
- Erythema nodosum and other skin lesions
- Fatigue
- Weight loss
- Arthralgias
- Cardiopulmonary
- Restrictive cardiomyopathy
- Arrhythmias due to conduction disturbance
- Endocrine
- Ocular
- Dacryoadenitis (lacrimal duct inflammation)
- Optic neuritis
- Iritis
Differential Diagnosis
- Malignancy
- Tuberculosis
- Coccidioidomycosis
- Histiocytosis X
- Wegener's granulomatosis
- Churg-Strauss syndrome
- Lupus
- Rheumatoid arthritis
- Polymyalgia rheumatica
Evaluation
- Definitive initial diagnosis unlikely to be made in ED, but may be suggested by typical granulomatous lesions seen on CT or other imaging in setting of appropriate clinical context
- Evaluate for complications/alternative diagnoses of presenting symptoms
Management
- Corticosteroids
- Treat complications
Disposition
- Dependent on presentation