Description sarcoidosis
Sarcoidosis is a multisystem granulomatous disease of uncertain origin. Multisystem means that affects multiple systems. Although the possible manifestations of sarcoidosis meet almost any tissue (in each body) predominates significantly impaired respiratory system, particularly lung and intrathoracic lymph nodes. Typical is granuloma formation – hence sarcoidosis among granulomatous disease. Granulomas are bearings in the tissue where there is a cluster of cells of the immune system respond to still unknown stimulus.
It is still a matter of speculation whether the underlying cause of sarcoidosis is an infectious agent(bacteria, viruses, or other), or whether it is one of the general immune reactions in sensitized individuals on various factors (inanimate) – ie. An allergic reaction to bacteria (mycobacteria, borreliae ), viruses and certain metals (e.g. zirconium). 90% of patients with sarcoidosis have affected intrathoracic lymph nodes and lungs, usually accompanied by dry cough and dyspnea, and therefore is most often treated to sarcoidosis lung compartment.
Sarcoidosis affects more women than men at a ratio of 1.5-2.0: 1st Among the patients are more non-smokers than smokers, and in the vast majority of these adults aged 30-50 years. Children are rarely affected.
The diagnosis of sarcoidosis is compiled on the basis of clinical symptoms, radiologic examinations (X-rays) and biopsy findings of epithelioid granulomas in affected organs. Called. Kveimův testtoday infekciozity out of fear of the disease and the possible risk of HIV infection has been undertaken (the essence of the response elicited after sample application sarcoid tissue from another sick individual patient who is supposed sarcoidosis).
Risk factors for sarcoidosis
Risk factors have not been disclosed.
prevention of sarcoidosis
Prevention of the disease is not known.
symptoms of sarcoidosis
Sarcoidosis most commonly affects intrathoracic lymph nodes. Such status is not necessarily clinically manifest, so sometimes it is also a random X-ray findings, which may not require treatment – such a condition called asymptomatic (ie. Symptomless) sarcoidosis.
The complete opposite is the form with an acute course and symptoms of an infection – fever, sore throat, muscle pain (arthralgia) and swelling around the ankles (edema perimaleolárními, maleolus – Latin ankle, peri – Latin for around). If these symptoms added more skin rash called erythema nodosum (erythema nodosum), enlarged lymph nodes and intrathoracic negative tuberculin skin test (used for the detection of tuberculosis), we talk about. Löfgrenově syndrome, which is a totally Line segment most common variant of sarcoidosis. Erythema nodosum is more or less symmetrical reddening of the skin especially in the areas of the lower legs. Swelling in the ankle are light pink, hot and painful. Löfgrenův syndrome indicates a good prognosis.
Last progressive variant of sarcoidosis is a chronic form, for which most consider the condition lasting at least two years, although it is often very difficult to determine the onset of the disease.
According to the radiographic finding of sarcoidosis is divided into three stages. At the first stagethey are affected only intrathoracic lymph nodes, which are remarkably enlarged, and both sides (bilateral hilar lymphadenopathy – BHL syndrome). In the second stage nodes are still enlarged, but less than before and are also affected lung. In the third stage they are already affected only lungs. Among the common symptoms usually include dry (nonproductive) cough, shortness of breath, fatigue, and sometimes loss of appetite and weight loss. Symptoms depend not form which the patient is experiencing (see above).
Sarcoidosis respiratory
Sarcoidosis respiratory tract is most often manifested a dry cough and shortness of breath. They can be affected not only the lung but also the upper airways and sinuses. Sometimes it is also present pain behind the breastbone, which is probably caused by enlarged lymph nodes mezihrudními. Out of symptoms appearing temperature or drowsiness. Expectoration of blood is rare and generally correlates with mucous membrane congestion or possible infection.
Sarcoidosis of the lymph nodes and spleen
These include very typical of disability, especially swelling of intrathoracic lymph nodes, which is reversible and often symmetrical. Nodes may be enlarged broadly throughout the body, they may not be enlarged symmetrically. They are not painful or red. When lymph node enlargement is usually enlarged and the spleen (splenomegaly).
sarcoidosis eye
It occurs in approximately 25% of patients. It manifested as inflammation of the eye to different eye level – mainly as a nonspecific inflammation of the conjunctiva (conjunctivitis, hereinafter iridocyclitis, uveitis posterior, and others). Sarcoidosis can cause cataracts (cataract), vitreous opacities, glaucoma (glaucoma). You can also meet with disabilities lacrimal glands and the emergence of so-called. Sicca syndrome or dry eye syndrome.
sarcoidosis skin
Sarcoidosis of the skin (30% disability) in acute form manifests itself as so-called. Erythema nodosum – mostly subcutaneous spots on the lower legs reminiscent of absorbing a hematoma (bruising). In the context of chronic disability we can meet with the formation of granulomatous nodules red color, which can reach up to 5 cm. The most common localization include the face, back of the arms, torso and front legs. Sarcoidosis occurs typically in the scar (then referred to as sarcoid).
Sarcoidosis of the musculoskeletal system
Up to one quarter of those affected joints. It manifested by pain and possible the emergence of deformities such as in rheumatoid arthritis. The bones may be present cystic changes (creation of voids with the content), which were described as Jünglinge ostitis cystoides multiplex – therefore Junglingova disease. Musculo is very rare.
Sarcoidosis nervous system
It is rare, affecting less than 10% of patients. It can affect both the central and peripheral nervous system. In connection with the impairment of the central system can also affect the optic nerve and cause blindness. When the affection of the peripheral nervous system (neuropathy) can ill often complain of fatigue, which is difficult to treat.
sarcoidosis heart
Clinically significant affects less than 5% of patients. It seems that more Japanese are suffering.This may appear as cardiac insufficiency, or pain behind the breastbone. However, the most serious rhythm disturbances (arrhythmias), which could result in sudden death.
Sarcoidosis of other organs
Among other possible affected organs may be the liver, stomach, intestine, kidney, pancreas, thyroid gland. It seems that the bladder or adrenal sarcoidosis penalized.
treatment of sarcoidosis
Treatment of sarcoidosis is initiated only when the subjective data breathlessness backed, lung function tests and observation worse lung function, or at least 6 months unchanging (nelepšícím) or deteriorating film findings. Further treats ocular sarcoidosis, sarcoidosis heart muscle, central nervous system and at increased levels of calcium in the blood or urine. In these cases, deploying therapy with glucocorticoids, which are substances absorbing immune system. Glucocorticoids there should be administered at least half a year. For ophthalmic and cutaneous sarcoidosis glucocorticoids also used topically, i.e. in the form of ointments and creams.
Sarcoidosis prognosis is quite good, almost 70-80% of patients are cured spontaneously without treatment, the remaining third requires treatment. It is reported that mortality from sarcoidosis is less than 5%.
How can I help myself
If you suffer from sarcoidosis, observe the treatment and avoid possible infections. If you suspect an illness from this disease, it would be best if you search for a doctor who will examine you and possibly sent to a specialized clinic.
complications of sarcoidosis
A serious complication of the disease is both chronic evolution and secondly impaired eye, nervous system and heart. Like not know the exact cause of the disease is not known why some individuals the disease passes into chronicity.