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2.1
Acute Sarcoidosis
Löfgren syndrome

Presentation

Thus, a patient with sarcoidosis may present with back pain or sacroiliac pain. [emedicine.medscape.com]

Peritoneal involvement is a rare presentation of sarcoidosis. Clinical presentation depends on the extent of organ involvement. In some cases,symptoms are no specific and uncommon findings have been reported so far. [ncbi.nlm.nih.gov]

The lungs are often involved and respiratory symptoms may also be present such as: Dry cough Breathlessness (dyspnoea) or rapid breathing (tachypnoea) Rintakipu Non-respiratory symptoms are also often present (see list below) and a full clinical examination [sarcoidosisuk.org]

Entire Body System

  • Pain

    In addition, inflamed muscles and joints, which can cause chronic pain in the affected areas, are also potential complications of sarcoidosis. [news-medical.net]

    Simple lifestyle changes and over-the-counter painkillers (such as paracetamol or ibuprofen) are often all that's needed to control the pain of any flare-ups. [nhs.uk]

    […] or a red eye Peripheral nodes Enlarged liver or spleen, abdominal pain Skin disorders Joint pains Testing for childhood sarcoidosis should be extensive. [sarcoidosisuk.org]

    MATERIAL OF STUDY: A 69 year-old woman was referred to our emergency department with diffuse abdominal pain, enteric vomiting and constipation. Abdominal CT showed a dilatated small bowel loops extended to the jejunum with a mechanical obstruction. [ncbi.nlm.nih.gov]

  • Inflammation

    The resulting inflammation then causes granulomas to develop in the organs. There are many similar conditions, such as rheumatoid arthritis and lupus, that are caused by the body attacking its own tissues. [nhs.uk]

    DISCUSSION: Sarcoidosis is a chronic multisystemic disorder of unknown aetiology with granulomatous inflammation. Peritoneal involvement is a rare presentation of sarcoidosis. Clinical presentation depends on the extent of organ involvement. [ncbi.nlm.nih.gov]

    The tests include: Blood tests including inflammation tests, calcium, liver and kidney function, immune tests and Angiotensin Converting Enzyme (ACE) which may be raised. [sarcoidosisuk.org]

    T-cell dysfunction and increased B-cell activity result in local immune hyperactivity and inflammation. [amboss.com]

  • Lymphadenopathy

    References:[6][7][1][8][9][10] Subtypes and variants Stages Chronic sarcoidosis Chest x-ray findings Stage 0 Normal findings Stage I Bilateral hilar lymphadenopathy (reversible)* Stage II Bilateral reticular or ground-glass opacities with hilar lymphadenopathy [amboss.com]

    Löfgren's syndrome, a specific phenotype of acute sarcoidosis, is characterised by bihilar lymphadenopathy, ankle arthritis and erythema nodosum. Chronic sarcoidosis can be asymptomatic, despite radiological changes, which may be extensive. [ncbi.nlm.nih.gov]

    A chest X-ray and a high-resolution CT-scan to search for thoracic lymphadenopathies (enlarged lymph nodes in the chest), interstitial lung disease and/or signs of fibrosis (damaged tissue) A lung bronchoscopy with bronchoalveolar lavage (a procedure [sarcoidosisuk.org]

    Sarcoidosis and cancer may mimic one another, making the distinction difficult.[25] The combination of erythema nodosum, bilateral hilar lymphadenopathy, and joint pain is called Löfgren syndrome, which has a relatively good prognosis.[20] This form of [en.wikipedia.org]

  • Swelling

    This results in inflammation (swelling and redness) of the body tissues in that area. The immune system responds like this to anything in the blood it does not recognise, and dies down when the infection has been cleared. [nhs.uk]

    17] Common symptoms, which tend to be vague, include fatigue (unrelieved by sleep; occurs in up to 85% of cases [18]), lack of energy, weight loss, joint aches and pains (which occur in about 70% of cases),[19] arthritis (14–38% of cases), dry eyes, swelling [en.wikipedia.org]

  • Hodgkin Lymphoma

    anemia, leukopenia, and/or thrombocytopenia) Non-Hodgkin lymphoma Infections (e.g., EBV infection or Helicobacter pylori) Cell damage (caused by toxic substances, immunosuppressive drugs, cytostatic therapy, radiation) Indolent lymph node enlargement [amboss.com]

    [151] and cancer in other organs known to be affected in sarcoidosis.[152][153] In sarcoidosis-lymphoma syndrome, sarcoidosis is followed by the development of a lymphoproliferative disorder such as non-Hodgkin lymphoma.[154] This may be attributed to [en.wikipedia.org]

Gastrointestinal

  • Abdominal Pain

    MATERIAL OF STUDY: A 69 year-old woman was referred to our emergency department with diffuse abdominal pain, enteric vomiting and constipation. Abdominal CT showed a dilatated small bowel loops extended to the jejunum with a mechanical obstruction. [ncbi.nlm.nih.gov]

    […] or a red eye Peripheral nodes Enlarged liver or spleen, abdominal pain Skin disorders Joint pains Testing for childhood sarcoidosis should be extensive. [sarcoidosisuk.org]

  • Vomiting

    MATERIAL OF STUDY: A 69 year-old woman was referred to our emergency department with diffuse abdominal pain, enteric vomiting and constipation. Abdominal CT showed a dilatated small bowel loops extended to the jejunum with a mechanical obstruction. [ncbi.nlm.nih.gov]

    […] results being obtained with apremilast in cutaneous sarcoidosis in a small open-label study.[130][131] Pentoxifylline has been used successfully to treat acute disease although its use is greatly limited by its gastrointestinal toxicity (mostly nausea, vomiting [en.wikipedia.org]

  • Diarrhea

    […] obtained with apremilast in cutaneous sarcoidosis in a small open-label study.[130][131] Pentoxifylline has been used successfully to treat acute disease although its use is greatly limited by its gastrointestinal toxicity (mostly nausea, vomiting, and diarrhea [en.wikipedia.org]

  • Nausea

    […] successful results being obtained with apremilast in cutaneous sarcoidosis in a small open-label study.[130][131] Pentoxifylline has been used successfully to treat acute disease although its use is greatly limited by its gastrointestinal toxicity (mostly nausea [en.wikipedia.org]

Musculoskeletal

  • Arthralgia

    Systemic symptoms include fatigue, night sweats, weight loss, fever, arthralgia and myalgia. [ncbi.nlm.nih.gov]

    Acute sarcoidosis has an abrupt onset with constitutional symptoms (e.g., fever, malaise) as well as cough, dyspnea, anterior uveitis, erythema nodosum, and arthralgia, and it is self-limiting after a few years. [amboss.com]

  • Myalgia

    Systemic symptoms include fatigue, night sweats, weight loss, fever, arthralgia and myalgia. [ncbi.nlm.nih.gov]

Neurologic

  • Neurologic Manifestation

    Given the wide a range of neurologic involvement, patients may present with virtually any neurologic complaint. [emedicine.medscape.com]

    manifestation of sarcoidosis.[55][56] It occurs suddenly and is usually transient. [en.wikipedia.org]

  • Hyperactivity

    T-cell dysfunction and increased B-cell activity result in local immune hyperactivity and inflammation. [amboss.com]

    Upper respiratory tract - Nose, tonsils in 20% Salivary glands - Parotitis Musculoskeletal - Acute or chronic arthritis; see Lofgren syndrome, below Kidney - Mainly as a kidney stone secondary to hypercalcemia; hypercalcemia is produced by calcitriol hyperactivity [emedicine.medscape.com]

Workup

"Sarcoidosis Workup". Medscape Reference. WebMD. Archived from the original on 1 March 2014. Retrieved 19 February 2014. ^ Allmendinger A, Perone R (2009). "Case of the Month". Diagnostic Imaging. 31 (9): 10. ^ Joanne Mambretti (2004). [en.wikipedia.org]

Treatment

Prednisone treatment is instituted, as discussed earlier. [emedicine.medscape.com]

An approach to the treatment of pulmonary sarcoidosis with corticosteroides. The six phases of treatment. Chest. 1999;115:1158–1165. [PubMed] [Google Scholar] Articles from Atencion Primaria are provided here courtesy of Elsevier [ncbi.nlm.nih.gov]

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. Medicines If treatment is recommended, steroid tablets are usually used. [nhs.uk]

[…] as a treatment for cases with liver involvement.[129] Thalidomide has also been tried successfully as a treatment for treatment-resistant lupus pernio in a clinical trial, which may stem from its anti-TNF activity, although it failed to exhibit any efficacy [en.wikipedia.org]

It seems that around half of children with sarcoidosis require no further treatment in adulthood. [sarcoidosisuk.org]

Prognosis

The long-term prognosis is generally good, but depends on the different organ manifestations and complications. Georg Thieme Verlag KG Stuttgart · New York. [ncbi.nlm.nih.gov]

Additional tests can help determine the severity of the disease, possible complications, and prognosis. [amboss.com]

Studies performed to correlate the presence of these markers with prognosis were not conclusive. [emedicine.medscape.com]

Sarcoidosis Diagnosis Sarcoidosis Treatment Sarcoidosis Prognosis Last Updated: Apr 13, 2021 Written by Susan Chow Susan holds a Ph.D in cell and molecular biology from Dartmouth College in the United States and is also a certified editor in the life [news-medical.net]

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 [en.wikipedia.org]

Etiology

Etiology The cause of sarcoidosis is still unknown;. Current hypotheses suggest that the etiology is multifactorial. [amboss.com]

Sarcoidosis is a chronic noncaseating granulomatous disease of unknown etiology that affects many organs and tissues, most commonly the lungs. [emedicine.medscape.com]

"Lesson learned from ACCESS (A Case Controlled Etiologic Study of Sarcoidosis)". Proceedings of the American Thoracic Society. 4 (5): 453–6. doi:10.1513/pats.200607-138MS. PMID 17684288. ^ Cathcart S, Sami N, Elewski B (May 2012). [en.wikipedia.org]

Epidemiology

Epidemiology Bimodal distribution: 25–35 years old with a second peak for females 45–65 years old Sex: ♀ > ♂ (2:1) Prevalence: 10 times higher among African Americans than whites in the US. [amboss.com]

"The epidemiology of sarcoidosis in Rochester, Minnesota: a population-based study of incidence and survival". American Journal of Epidemiology. 123 (5): 840–5. doi:10.1093/oxfordjournals.aje.a114313. [en.wikipedia.org]

Pathophysiology

References:[3] Pathophysiology Sarcoidosis is a systemic disorder characterized by widespread, immune-mediated formation of noncaseating granulomas. [amboss.com]

The exact mechanism of this relation is not known, but some evidence supports the hypothesis that this is a consequence of Th1 lymphokine prevalence.[63][91] Tests of delayed cutaneous hypersensitivity have been used to measure progression.[92] Pathophysiology [en.wikipedia.org]

Prevention

This helps relieve symptoms and prevent damage to affected organs by reducing inflammation and preventing scarring. However, steroid tablets can cause unpleasant side effects such as weight gain and mood swings if taken in high doses. [nhs.uk]

Vaikka sarkoidoosi voi periaatteessa esiintyä myös sukupuolielimissä, tämä on onneksi hyvin harvinaista. raskaus Sarcoidosis does not prevent pregnancy or the birth of a healthy child. [sarcoidosisuk.org]

PMID 22004880. ^ Clinical trial number NCT01830959 for "Use of Roflumilast to Prevent Exacerbations in Fibrotic Sarcoidosis Patients (REFS)" at ClinicalTrials.gov ^ Belkhou A, Younsi R, El Bouchti I, El Hassani S (July 2008). [en.wikipedia.org]

The primary aims for treatment of ocular sarcoidosis are to restore vision and to prevent complications. The mainstay of treatment is topical, regional, and systemic corticosteroid therapy. [emedicine.medscape.com]

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