What Is Pulmonary Sarcoidosis
Sarcoidosis is a rare disease caused by inflammation. It usually occurs in the lungs and lymph nodes, but it can occur in almost any organ.
Sarcoidosis in the lungs is called pulmonary sarcoidosis. It causes small lumps of inflammatory cells in the lungs. These lumps are called granulomas and can affect how the lungs work. The granulomas generally heal and disappear on their own. But, if they dont heal, the lung tissue can remain inflamed and become scarred and stiff. This is called pulmonary fibrosis. It changes the structure of the lungs and can affect your breathing. Bronchiectasis can also occur. This is when pockets form in the air tubes of the lung and become infected. But, these problems are not common.
How Long Does It Take To Recover From Sarcoidosis
If your sarcoidosis appears suddenly, in many cases overnight, and you have large, tender, red, bumps on your legs , then you can expect to be free of disease within 12 to 18 months. If your illness develops gradually, over many months or years, it may last much longer, anywhere from several months to your entire lifetime.
What Are Symptoms Of Sarcoidosis When It Affects The Eyes
About 25% of people with sarcoidosis have eye symptoms. Inflammation of almost any part of the eye can occur–this includes the membranes of the eyelids, cornea, outer coat of the eyeball , iris, retina, and lens. The most common eye-related symptom is acute anterior uveitis , which results in the rapid onset of blurred vision, teary eyes, and light sensitivity. In long-standing disease, glaucoma, cataracts, and blindness can occur. Dry eyes are very frequent in long-standing sarcoidosis, even when there is no remaining inflammation. They can be treated with eye drops.Because some sarcoid-related eye problems do not cause symptoms, it is important that all patients with sarcoidosis have at least yearly appointments with an ophthalmologist.
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The Staging Of Pulmonary Sarcoidosis
Its estimated that at least 90% of patients with sarcoidosis will experience lung involvement. Chest x-rays are often used to determine the nature of the disease. However, the results of this imaging can cause confusion for sarc patients- your doctor might tell you that the images indicate a certain stage of sarcoidosis. What does this mean? Is it like the stages of cancer? Being told you have stage three or stage four pulmonary sarcoidosis sounds bad- but what does it really mean?
Hopefully, your doctor gives you an accurate explanation of what the stages mean. However, too often we hear from patients who are concerned about which stage they have, what it means, or how long until they progress to the next stage. The stages of sarcoidosis should not be viewed in the way that stages of cancer are- they do not indicate progression of the disease.
In cancer, staging is a way to indicate the size of the cancer tumors, if it has spread to surrounding tissue, or spread to other organs entirely. It indicates progression- in stage IV cancer, the cancerous cells have spread to other parts of the body, making it harder to recover from and requiring a more aggressive, full-body treatment.
In sarcoidosis, staging is a way to indicate the location of granulomas- the lungs, the lymph nodes, or both- and the nature of the disease. If anything, the stages are an easy way for doctors to categorize their sarcoidosis patients, and should not be seen as an indication of severity.
Does Sarcoidosis Affect Persons Sleeping Pattern
Only if the patient has enlarged tonsils and upper airway granulomas. In a sarcoidosis patient the presence of obesity might be the cause of sleep apnea and related breathing abnormalities. Rarely, hypothalamic involvement may cause sleep disturbances. Sleeping pattern may also be changed in CFS associated with sarcoidosis.
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What Is The Outlook For Someone With Sarcoidosis
The outlook is generally good for people with sarcoidosis. Many people live relatively healthy, active lives. Symptoms often improve with or without treatment in about 2 years.
In some cases, however, sarcoidosis can become a long-term condition. If you need help coping, you can talk with a psychotherapist or join a sarcoidosis support group.
What Are Symptoms Of Sarcoidosis When It Affects The Renal And Endocrine System
Abnormalities can occur in the way the body handles calcium. For example, hypercalcemia occurs in 2% to 10% of patients. Hypercalciuria occurs in up to 21% of patients. Kidney stone formation, damage to the structure of the kidney itself, and kidney failure may also occur. Another endocrine abnormality seen in sarcoidosis is hypopituitarism. The pituitary gland is at the base of the brain and secretes eight different hormones. The signs and symptoms of hypopituitarism vary, depending on which hormones are undersecreted. Occasionally, there is decreased secretion of all the hormones and this is called panhypopituitarism. Diabetes can occur as a complication of sarcoidosis therapy.
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How Is Sarcoidosis Diagnosed
Because the symptoms and laboratory findings associated with sarcoidosis can occur in other diseases, there is no single test that can diagnose it. However, the classic sign of the disease is the formation of granulomas in one or more of the major organs of the body. Sarcoidosis-related granulomas are not different from granulomas that occur in other diseases. As a result, a complete physical exam and medical history including occupational history, medication history, and environmental exposures must be made before concluding that the illness is, in fact, sarcoidosis.
How Sarcoidosis Is Treated
Most people with sarcoidosis do not need treatment as the condition often goes away on its own, usually within a few months or years.
Simple lifestyle changes and over-the-counter painkillers are often all that’s needed to control the pain of any flare-ups.
Doctors will monitor your condition to check if it’s getting any better or worse without treatment. This can be done with regular X-rays, breathing tests and blood tests.
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Key Points About Pulmonary Sarcoidosis
- Sarcoidosis is caused by inflammation. Most cases of sarcoidosis are found in the lungs and lymph nodes, but it can occur in almost any organ.
- Sarcoidosis in the lungs is called pulmonary sarcoidosis. It causes small lumps of inflammatory cells, called granulomas, in the lungs. They can affect how the lungs work.
- The cause of pulmonary sarcoidosis is unknown.
- The most common symptoms of pulmonary sarcoidosis are shortness of breath, which often gets worse with activity dry cough that will not go away chest pain and wheezing.
- Treatment is generally done to control symptoms or to improve the function of organs affected by the disease. Steroids are often used.
What Is Bronchoalveolar Lavage
A bronchoscope is a long, narrow tube with a light at the end. It is used to examine the breathing tubes and the lungs. It is also used to collect fluid from the lungs. This fluid is examined for various cells and substances that reflect the inflammation and immune changes in the lungs. This process is referred to as bronchoalveolar lavage .
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Sarcoidosis In The Lungs
If you have sarcoidosis in the lungs, you may experience these symptoms:
- Shortness of breath
- Chest pain
However, you can have sarcoidosis in the lungs without these symptoms. For example, skin rashes or sores can include erythema nodosum or lupus pernio. Lupus pernio causes skin sores that usually affect the face, especially the nose, cheeks, lips, and ears. These sores usually last a long time. Lupus pernio affects African American people more often than other groups.
Are There Alternative Treatments To Corticosteroids
Other treatments are available for patients who cannot tolerate steroids either because they are contraindicated or because side effects cannot be tolerated. Patients whose disease does not respond to steroids or who wish to lower the dose of steroids and use another drug in combination have additional treatment options as well.
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How Is Sarcoidosis Treated
There is no cure for sarcoidosis, but the disease may get better on its own over time. Many people with sarcoidosis have mild symptoms and do not require any treatment at all. Treatment, when it is needed, generally falls into two categoriesmaintenance of good health practices and drug treatment. Good health practices include:
- Getting regular check-ups with your health care provider.
- Eating a well-balanced diet with a variety of fresh fruits and vegetables.
- Drinking 8 to 10 8-ounce glasses of water a day.
- Getting 6 to 8 hours of sleep each night.
- Exercising regularly, and managing and maintaining your weight.
- Quitting smoking.
- Avoiding exposure to dust, chemicals, fumes, gases, toxic inhalants and other substances that can harm your lungs.
- Avoiding excessive amounts of calcium-rich foods , vitamin D and sunlight. Daily sunbathing is an example of excessive sunlight and should be avoided sunlight received from activities of everyday living is acceptable.
Drug treatments are used to relieve symptoms, reduce the inflammation of the affected tissues, reduce the impact of granuloma development, and prevent the development of lung fibrosis and other irreversible organ damage.
Corticosteroids are particularly effective in reducing inflammation, and are typically the first drugs used in treating sarcoidosis. The oral corticosteroid prednisone is the most commonly used corticosteroid.
- Excessive weight gain.
- Increased risk of infections.
Natural Ways To Manage Sarcoidosis
In many cases, sarcoidosis treatment does not involve medication. If your symptoms are mild or your disease is not affecting the eyes, heart or brain, you may need no treatment at all even natural ones!
However, it is generally a good idea to follow these lifestyle tips if you have been diagnosed with sarcoidosis:
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What Are The Side Effects Of The Other Drugs
Chloroquine does not have the same side effects as corticosteroids. However, if given for a long period of time it may cause damage to the eyes. Hydroxychloroquine does not have many side effects. Immunosuppressive drugs have more serious side effects such as increased susceptibility to infections, anemia, and suppression of the bodys ability to fight disease.
Can You Have Sarcoidosis In Other Organs But The Chest X
Yes, in ten percent of the sarcoidosis patients chest x-ray film may be normal. These patients may have skin, heart, brain, bones, or joint disease. It is also possible to have sarcoidosis in the lung without it showing up on your chest x-ray film. In such cases a CT examination of the chest is indicated.
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Will Smoking Affect My Disease
Smoking does not cause sarcoidosis, but if you have lung disease due to sarcoidosis, then smoking may worsen your breathlessness by adding new injury to your breathing tubes in the form of bronchitis or emphysema. You should be aware that any lung disease can be further compromised by smoking. If you smoke, and you have sarcoidosis, this is a good time to help your lungs by quitting your habit.
How Sarcoidosis Progresses: What Happens At The Tissue Level
At the tissue or cellular level, sarcoidosis disease progression can be divided into three phases:
- The first change that is seen is inflammation.
- In the second phase, granulomas form. Granulomas are masses or nodules of chronically inflamed tissue and are the classic sign of sarcoidosis Granulomas are the bodys attempt to wall off or isolate organisms and other foreign particles that are difficult for the immune system to eradicate or dispose of.
- In the third phase, fibrosis of tissues or organs occurs. If scarring is extensive in a vital organ, sarcoidosis is sometimes fatal.
In some people, the disease advances from one phase to the next in the tissues of the organ affected. In others, the different phases of tissue changes take place within the same organ at the same time. In many patients with sarcoidosis, the granulomas go away on their own in 2 to 3 years without the patient knowing or doing anything about them. In others, the granulomas progress to irreversible fibrosis. The immune system changes that allow one persons disease to progress while another persons disease resolves are not well understood and continue to be investigated.
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What Are Symptoms Of Sarcoidosis When It Affects The Nervous System
Neurologic disease occurs in 5% to 10% of patients, often without symptoms in other organs. Symptoms of neurologic involvement include headaches, meningitis, seizures, and nerve tissue degeneration or inflammation which results in muscle weakness, pain, and numbing or tingling sensations in the face, arms, and legs.
A more recently-discovered type of neurosarcoidosis is small fiber neuropathy . SFN causes a loss of some types of nerve fibers and requires specialized testing to identify it. Patients with SFN often note burning pain, sensitivity to touch, palpitations, sweating, flushing, light-headedness, gastrointestinal difficulties, and sexual dysfunction.
Sarcoidosis And Pain Caused By Small
1Department of Anesthesiology, Leiden University Medical Center, P5Q, Postbus 9600, 2300 RC Leiden, The Netherlands
2Department of Neurology, Diaconessenhuis Leiden, Leiden, The Netherlands
Sarcoidosis is a chronic inflammatory illness and small-fiber neuropathy is one of the disabling and often chronic manifestations of the disease. SFN presents with peripheral pain and symptoms of autonomic dysfunction. The character of the pain can be burning or shooting. Besides, allodynia and hyperesthesia can exist. Diagnosis is usually made on the basis of clinical features, in combination with abnormal specialized tests. The aim of treatment is often to reduce pain however, total pain relieve is seldom achieved. The role of TNF- in the pathogenesis of SFN in sarcoidosis appears interesting to explore. Novel therapeutic agents such as ARA 290, a nonhematopoietic erythropoietin analogue with potent anti-inflammatory and tissue protective properties, are interesting to explore in the treatment of SFN in sarcoidosis.
1. SarcoidosisA microscopical section of mediastinal lymph node with HE stain, ×40. Multiple granulomas with various sizes from 0,2 to 0,8mm in diameter are observed in the lymph node. These granulomas consist of histiocytes, which have large cytoplasm and partly connect to each other but lack a necrotic region.
2. Small Fiber Neuropathy
2.1. Diagnosis of Small Fiber Neuropathy
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Can You Tell Me About Congestive Cardiomyopathy Brought On By Long Term Pulmonary Involvement How Is It Treated
Long term pulmonary involvement causes failure of the right side of the heart called cor pulmonale. It is due to the lack of oxygen. You need to be on oxygen if your oxygen is low. Prednisone, chloroquine on hydroxychloroquine and methotrexate are the drugs used to treat sarcoidosis of the heart muscle.
Approach For Management Of Sarcoid Arthritis
iagnosis and management of patients with sarcoid arthritis. MTX, methotrexate SZA, sulfasalazine DMARD, disease modifying antirheumatic drugs NSAIDs, nonsteroidal antiinflammatory drugs PT/OT, physical therapy/occupational therapy biologics, anti-TNF agents , co-stimulatory agents B-cell depleting agents combination therapy, multiple DMARDs and/or a DMARD plus a biologic. *Low-dose steroids, < 10 to 20 mg prednisone daily **Suboptimal response to MTX, intolerance to drug, lack of satisfactory efficacy on dosage up to 25 mg/week, or a contraindication to medication use. ***DMARD failure, progressive disease or drug intolerance. ****Methylprednisone preferred over prednisone if prednisone has been used prior.
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What Are The Symptoms Of Pulmonary Sarcoidosis
Most people with sarcoidosis do not have symptoms and probably don’t know they have the disease. It can affect many organs, causing a variety of symptoms. Pulmonary sarcoidosis can reduce the amount of air the lungs can hold and cause lung stiffness.
The following are the most common symptoms of pulmonary sarcoidosis. However, each person may experience symptoms differently. Symptoms may include:
- Shortness of breath, which often gets worse with activity
- Dry cough that will not go away
- Chest pain
Sarcoidosis can also cause symptoms not directly related to the lungs, such as:
- Extreme tiredness
- Pain in the joints and bones
- Skin rashes, lumps, and color changes on face, arms, or shins
- Swollen lymph nodes
- Weight loss
The symptoms of pulmonary sarcoidosis may look like other conditions or medical problems. Talk with your healthcare provider for a diagnosis.
In Talking To Several Women Who Have Sarcoidosis I Discovered Some Of Us Have Severe Back Pain In The Muscle Along The Bra Line And Then Up The Middle It Is More Severe At Some Times Than Others Can You Shed Any Light As To The Cause
Back pain may be due to enlargement of the glands in the chest, muscle spasm, arthritis in the spine involvement of the nerves supplying the torso or even osteoporosis related to prednisone. In some cases pain in the chest may be due to the involvement of the lung lining or pleura. Thus, persistent back pain requires careful evaluation.
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