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Sarcoidosis - Coggle Diagram
Sarcoidosis
Treatment
Pharmacological
Immunosuppressive's
Antimalarials
Corticosteroids
TNF inhibitors
Many individuals do not need treatment
In serious cases
Lung transplant
Surgery
Pathophysiology
antigen triggers ongoing inflammatory response
activates cell-mediated immune response
accumulation of T cells and macrophages
release cytokines and chemokines
results in noncaseating granulomas in one or more organs or tissues, typically the lungs
cause unknown- attributed to genetic and environmental factors
Multisystem Alterations
Pulmonary Sarcoidosis
lungs are most common affected organ
may result in reduced lung function
categorized into four stages
Extrapulmonary Sarcoidosis
Musculoskeletal
involves joints, muscles, bones
Arthritic Syndromes
acute
chronic
muscle involvement has three forms
chronic myopathy
the most common form
causes symmetric proximal weakness
nodular myopathy
characterized by the accumulation of large granulomas and dense connective tissue into nodules
acute myopathy
least common
rapid onset of proximal weakness and myalgias over several weeks
typically presents as present as an inflammatory arthritis with periarticular soft-tissue swelling, tenosynovitis, dactylitis, osteopenia and associated myopathy.
Opthalmologic
inflammation either within the eye or in adnexal structures
causes Uveitis
Symptomsmay include tearing, photophobia, pain, and injection; may also be asymptomatic
Neurologic
any part of nervous system can be affected
most commonly the cranial nerves, meninges, and brain parenchyma
most common manifestation is cranial nerve dysfunction
Granulomatous involvement of the brain parenchyma is the most serious complication
leads to dysfunction of the hypothalamic-pituitary axis
Cardiac
leading cause of death in sarcidosis
granulomatous inflammation of myocardium
leads to
arrhythmia
cardiomyopathy
may be asymptomatic or present with palpitations, syncope, or sudden cardiac death
Cutaneous
non-specific lesions
erythema nodosum
painful nodules on the lower legs
indicates an acute form of sarcoidosis
specific lesions
papular/plaque lesions
Papular lesions occur commonly on the face, often around the eyes. Maculopapular lesions tend to favor the neck and trunk
lupus pernio
violaceous, indurated lesions on the face,
subcutaneous nodules
caused by granulomatous inflammation of adipose tissue underneath the skin and commonly found on the extremities
Gastrointestinal
rare
granulomatous infiltration in the mucosa and muscular layer
leads to
mucositis, ulcer, obstruction, or stricture
manifestations include
vomiting
weight loss
nausea
diarrhea
can be asymptomatic
Over half of patients with gastric sarcoidosis present with epigastric pain
Renal
most common is granulomatous interstitial nephritis
Calcium metabolism may be dysregulated, resulting in hypercalciuria, hypercalcemia, and nephrolithiasis with possible renal insufficiency
due to
Granulomatous inflammation activates vitamin D and leads to increased absorption of calcium from the gastrointestinal tract.
Sterile pyuria, proteinuria, and microscopic hematuria may occur
Clinical Manifestations
Symptoms depend on the organs affected
May be asymptomatic
Nonspecific manifestations
Fever
Fatigue
Night sweats
Weight loss
Dry cough
Dyspnea with chest discomfort