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03-18-2009, 10:47 AM
Sarcoidosis
Def. It is a disease characterized by T.cell dysfunction

noncaseating granuloma with interstitial lung disease
C/P
1- lung interstitial pulmonary diseases (as above)
2- Extrapulmonary manifestation.
Heart Skin C.N.S(neuro) L.N.++,
Cardiomyopathy Erythema nodosum Bilateral Fascial Liver ++
Paralysis Spleen++
Eye D.I Hypercalcemia
Retinitis, uveitis (It affects post due to secretion
hypertrophy of lacrimal pituitary gland) of activated vit.D.
glands from macrophage
Diagnosis:
1- Nr.
1- X-ray stages 2- Hilar L.N.
3- interstitial pulmonary diseases + hilar L.N.
4- Interstitial pulmonary diseases.
­ S.Ca - ­ ESR
hypoxia (by blood gases) due to diffusion defect
bconchoalveolar lavage showing lymphocytes ­­.
Transbcochial biospsy from lung showing non caseating granuloma
High serum level of converting enzyme
Tuberculin is -ve in 80% of cases.
Kveim test by intrademal injection of sarcoid tissue.
Treatment:
We give steroids with the following:
*C.N.S. involvement.
*Eye lesions
*Pulmonary function

D.D of Generalized lymphadenopathy:
1- Leukaemia. 4-AIDS 7- Brucellosis
2- lymphoma 5- Infectious mononucleosis
3- Sarcoidosis 6- T.B. 8- C.M.V


Source: Internal Medicine Book of Dr.Osama Mahmoud (Ain Shams University)