Sarcoidosis

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0 height="100%"><tr> <td valign="top" width=230 BGCOLOR="#FFFFFF" TEXT="#080000" bgproperties="fixed" background="15fe6962egerdp.jpg"> <div> <B><IMG SRC="161b4e60.jpg" border=0 width="180" height="230" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></div> <div> <A HREF="id10.htm" TARGET="_top" TITLE="Chronic Obstructive Lung Disease"><U><B>Chronic Obstructive Lung Disease</B></U></A></div> <div> <A HREF="id8.htm" TARGET="_top" TITLE="Asthma"><U><B>Asthma</B></U></A></div> <div> <A HREF="id9.htm" TARGET="_top" TITLE="Lung Cancer"><U><B>Lung Cancer</B></U></A></div> <div> <A HREF="id31.htm" TARGET="_top" TITLE="Idiopathic Pulmonary Fibrosis"><U><B>Idiopathic Pulmonary Fibrosis</B></U></A></div> <div> <B>Sarcoidosis</B></div> <div> <A HREF="id63.htm" TARGET="_top" TITLE="Severe Acute Respiratory Syndrome"><U><B>Severe Acute Respiratory Syndrome</B></U></A></div> <div> <A HREF="id64.htm" TARGET="_top" TITLE="Avian Flu"><U><B>Avian Flu</B></U></A></div> <div> <A HREF="id32.htm" TARGET="_top" TITLE="Disclaimer"><U><B>DISCLAIMER</B></U></A></div> <div> <A HREF="id40.htm" TARGET="_top" TITLE="Notice of Privacy Practices"><U><B>Notice of Privacy Practices</B></U></A></div> <bR> </td> <td valign="top" BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <B>Richard W Pomerantz, MD, PA</B></div> <div> Board Certified in Pulmonary & Critical Care Medicine<FONT SIZE="1" COLOR="#000000" FACE="Arial" >     |    </FONT><FONT SIZE="1" COLOR="#0000BF" FACE="Arial" ><A HREF="index.htm" TARGET="_top" TITLE="Richard W Pomerantz, MD, PA"><U> home</U></A></FONT></div> <div> <FONT SIZE="1" COLOR="#000000" FACE="Arial" >back to</FONT>  <A HREF="id3.htm" TARGET="_top" TITLE="Medical Conditions"><U><B>Medical Conditions</B></U></A></div> <div> Sarcoidosis</div> <div> What is Sarcoidosis?</div> <div> Sarcoidosis is a disease which can best be described by small areas of abnormal tissue inflamation which causes the formation of granuloma in various organs of the body. These granuloma can be either inside the body or on the body's exterior. They can appear on the walls of the alveoli (small air sacs in the lungs) or on the walls of the bronchioles (breathing tubes in the lungs). The granulomas can also appear as sores on the face or shins. Most sarcoidosis patients do not even have any symptoms and probably never know they have the disease. Sarcoidosis is not contagious. The disease can attack any organ of the body in any location, but it is most frequently found in the lungs. Pulmonary sarcoidosis can cause loss of lung volume (the amount of air the lungs can hold) and abnormal lung stiffness. Medical science does not know the cause of sarcoidosis.</div> <div> What Are the Symptoms of Sarcoidosis?</div> <div> Most sarcoidosis patients have no symptoms at all. In pulmonary sarcoidosis, patients may have a dry cough (without sputum), shortness of breath, or mild chest pain. There also can be fatigue, weakness, and weight loss. These symptoms are common in many other lung diseases, so diagnosis may be difficult. In those cases where symptoms do appear outside the lung, they can include a scaly rash, red bumps on the legs, fever, soreness of the eyes, and pain and swelling of the ankles.</div> <div> How Is Sarcoidosis Diagnosed?</div> <div> Any of the symptoms listed in the previous section may lead a physician to consider sarcoidosis. Sarcoidosis is initially diagnosed based on physical examination, laboratory tests, pulmonary function studies, and chest X ray. When enlargement of lymph glands in the center of the lungs is seen on the X ray, sarcoidosis may be suspected. To confirm the diagnosis, a biopsy is usually performed on any of the affected organs or from material in a granuloma on the skin. Bronchoscopy may also help in making a diagnosis by sampling cells within the lung.  Often bronchoscopy can help patients avoid a more invasive lung biopsy.</div> <div> How Serious Is Sarcoidosis?</div> <div> About 50% of sarcoidosis patients improve spontaneously, without any treatment. The disease is fatal in less than 5% of patients. In between the two extremes, patients have mild to severe sarcoidosis, with various degrees of impairment -- or none at all.</div> <div> Who Gets Sarcoidosis?</div> <div> Sarcoidosis is found throughout the world within almost all races and ages and in both sexes. However, it is most common among African Americans and northern European whites. Sarcoidosis is mainly a disease of young adults -- patients between the ages of 25 and 40, although a few persons past 60 have been known to have it. In the United States, a higher percentage of African Americans than whites have sarcoidosis, and the disease is usually more serious in them. The prevalence of sarcoidosis is 8 times greater in African Americans than whites in the U.S.</div> <div> What Causes Sarcoidosis?</div> <div> No one knows for sure the cause of sarcoidosis, despite very extensive research.  Some physicians believe sarcoidosis results from inhalation of an infectious or allergic substance from the environment. Others believe that the disease is a basic problem in alteration of the cellular immune system.  Like many other diseases, we may eventually find that sarcoidosis is a combination of genetic factors and environmental exposures.</div> <div> What Body Sites Does Sarcoidosis Attack?</div> <div> Ninety percent of the cases of sarcoidosis have involvement in the lungs.  Other areas involved less commonly include: skin, liver, lymph glands, spleen, eyes, nervous system, musculoskeletal system (muscles and bones in the body), heart, brain, and kidneys. Involvement of the lungs usually occurs along with these other areas, although not always.</div> <div> What Is the Common Course of Sarcoidosis?</div> <div> In most cases of sarcoidosis that have no symptoms, the disease "burns itself out," disappearing with little or no notice to the patient or physician. If pulmonary sarcoidosis is serious, it can develop into pulmonary fibrosis (the abnormal formation of fiber-like scar tissue in the lung). This actually distorts the structure of the lungs and can interfere with breathing, especially the ability to exchange oxygen in the lung.</div> <div> What Is The Treatment for Sarcoidosis?</div> <div> In a majority of patients, the disease spontaneously disappears, and no treatment is necessary. Drugs called corticosteroids (for example: prednisone) are the most important treatment used in fighting sarcoidosis. In general, physicians prescribe steroids when the patient has certain worrisome symptoms or laboratory findings. Published guidelines are available to assist physicians in using these medicines appropriately.  Treatment should be initiated and monitored closely by physicians that are experienced in treating sarcoidosis. Treatment is often started with daily medications, and tapered down slowly, sometimes to alternate day dosing. </div> <div> What Can the Sarcoidosis Patient Do?</div> <div> The sarcoidosis patient should follow his or her doctor's directions. This frequently can be just continuation of a normal lifestyle. When drugs are prescribed, they should be taken faithfully, just as the physician directs. It is particularly important that patients with sarcoidosis do not smoke.  Most physicians also recommend yearly eye exams.</div> <div> In Summary</div> <div> Sarcoidosis -- which has an unknown cause -- can be serious in some people, even causing death. Generally though, the disease is not serious, coming and going and then disappearing. In many patients, sarcoidosis does not have symptoms. When there are granulomas, corticosteroids are most often used to combat the inflammation.</div> <DIV ALIGN="LEFT"></DIV> <div> <I>Source:  Adapted From Various Sources </I></div> <div> <I>Last Updated: 6/02</I></div> <div> ____________________________________________________________________________</div> <div> <B>Disclaimer</B></div> <div> This information is for general informational purposes only. The information contained within this document, and any other sources referenced may not be specific to your medical needs, nor relevant to your condition. Always consult your physician for information specific to your needs or condition. Information in this document may be from several sources, appropriate references have been made - where available. 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