What is Sarcoidosis?

a multisystem disorder of unknown aetiology characterised by non-caseating granulomas

What patient groups is Sarcoidosis most common?

more common in young adults and in people of African descent

What are the acute features of Sarcoidosis?

• erythema nodosum
• bilateral hilar lymphadenopathy
• swinging fever
• polyarthralgia

What are the insidious features of Sarcoidosis?

• dyspnoea
• non-productive cough
• malaise
• weight loss

What is a common form of cutaneous sarcoidosis?

lupus pernio

Why is hypercalcaemia seen in Sarcoidosis?

macrophages inside the granulomas cause an increased conversion of vitamin D to its active form

What is Lofgren's syndrome?

an acute form of sarcoidosis characterised by bilateral hilar lymphadenopathy (BHL), erythema nodosum, fever and polyarthralgia. It usually carries an excellent prognosis

What is Heerfordt's syndrome?

there is parotid enlargement, fever and uveitis secondary to sarcoidosis

What abnormalities may been seen in routine bloods in Sarcoidosis?

hypercalcaemia (seen in 10% if patients) and a raised ESR

What may be found on spirometry in Sarcoidosis?

restrictive defect

What will be found on tissue biopsy in Sarcoidosis?

non-caseating granulomas

What are the Indications for steroids in Sarcoidosis?

• patients with chest x-ray stage 2 or 3 disease who are symptomatic
• hypercalcaemia
• eye, heart or neuro involvement

In sarcoidosis what Factors associated with poor prognosis?

• insidious onset, symptoms > 6 months
• absence of erythema nodosum
• extrapulmonary manifestations: e.g. lupus pernio, splenomegaly
• CXR: stage III-IV features
• black African or African–Caribbean ethnicity