1. 10.7.09

2. 10.17.09

9. Sarcoidosis morning report 12.21.09 Alisa Alker

10. Sarcoidosis multisystem granulomatous disorder of unkown etiology prevalence: ~ 20 per 100,000 more common in Blacks and Scandinavians usually presents between ages 10-40

11. Clinical presentation Sarcoidosis can affect many organs but 90% have lung involvement typically presents with cough, dyspnea, fatigue, fever, weight loss

12. Radiology Stage I - bilateral hilar adenopathy stage 2 - bilateral hilar adenopathy + reticular opacities stage 3- reticular opacities with shrinking hilar nodes stage 4- reticular opacities with evidence of volume loss. conglomerated masses with bronchiectasis or cavitation may be seen

13. More radiology up to 40% have parenchymal involvement such as interstitial inflitrates, fibrotic appearing infiltrates usually more pronounced in the upper airways and often asymmetric

14. Extrapulmonary most common organs affected: Skin, lymph nodes, eye, liver skin: erythema nodosom, macupapular eruption, eye: anterior or posterior uveitis liver: hepatomegally with or without granulomas

15. Diagnosis compatible clinical and radiographic manifestations exclusion of other diseases that may present similarly (histo, TB, berylliosis, eosinophilic granuloma, hypersensitivity pneumonitis histopathology demonstrating noncaseating granulomas

16. Treatment/prognosis systemic corticosteroids or cytotoxic agents (azathioprine or methotrexate) many patients are asymptomatic 60% of patients have spontaneous resolution mortality rate is 1-6%

17. smoking & sarcoidosis Is there a relationship between smoking and sarcoidosis? Douglas 1986: people diagnosed with sarcoidosis (n=202) had a lower prevalence of smoking that the general public (22 vs 43%) Valeyre 1988: case control study (n=131) no association between smoking and the occurence or severity of sarcoidosis

18. References Dempsey OJ, Paterson EW, Kerr KM, Denison AR. Sarcoidosis. BMJ. 2009;339:b3206. Douglas JG, Middleton WG, Gaddie J, Petrie GR, Choo-Kang YF, Prescott RJ, et al. Sarcoidosis: a disorder commoner in non-smokers? Thorax. 1986 Oct;41(10):787-791. Polychronopoulos VS, Prakash UBS. Airway involvement in sarcoidosis. Chest. 2009 Nov;136(5):1371-1380. Talmadge K. Clinical manifestations and diagnosis of sarcoidosis. UpToDate. 2009 Oct 1; Valeyre D, Soler P, Clerici C, Pre J, JP Battesti, Georges R, et al. Smoking and pulmonary sarcoidosis: effect of cigarette smoking on prevalence, clinical manifestations, alveolitis, and evolution of disease. Thorax. 1988;43:516-524.

19. Happy Holidays