1. Sarcoidosis Bryan Imayanagita 10/22/10 UCI T-RAP

2. Background Besnier-Boeck disease Besnier-Boeck disease Abnormal collection of inflammatory granulomas Abnormal collection of inflammatory granulomas 20-40 years year old. Scandinavian, blacks 20-40 years year old. Scandinavian, blacks Commonly affects lungs Commonly affects lungs

3. Pathophysiology Exact cause unknown Exact cause unknown accumulation of monocytes, macrophages and activated T-lymphocytes accumulation of monocytes, macrophages and activated T-lymphocytes Macrophage increase inflammation while immune response suppressed Macrophage increase inflammation while immune response suppressed Genetic Factors: BTNL-2 gene (possibility) Genetic Factors: BTNL-2 gene (possibility)

4. Symptoms Signs often vague and hard to distinguish Signs often vague and hard to distinguish Fatigue, aches, pains, rashes Fatigue, aches, pains, rashes Enlarged lymph nodes Enlarged lymph nodes Mimics cancer Mimics cancer Can be asymptomatic Can be asymptomatic

6. Diagnosis Process of elimination Process of elimination CT, chest X-ray, PET scan to exclude in pulmonary cases CT, chest X-ray, PET scan to exclude in pulmonary cases Differential diagnosis: metastatic disease, lymphoma, septic emboli, etc Differential diagnosis: metastatic disease, lymphoma, septic emboli, etc Women: association with hypo/hyperthyroidism Women: association with hypo/hyperthyroidism

7. Stage IV Sarcoidosis

8. Treatment 30-70% don’t require treatment 30-70% don’t require treatment Corticosteroids (prednisone) Corticosteroids (prednisone) Follow up: EKG, liver, calcium tests Follow up: EKG, liver, calcium tests

9. Prognosis Can remit spontaneously or become chronic Can remit spontaneously or become chronic Half cured in 12-36 months. Most in 5 years Half cured in 12-36 months. Most in 5 years heart problems heart problems Higher cancer risks Higher cancer risks

10. Sources http://www.merck.com/mmhe/sec04/ch050 /ch050e.html http://www.merck.com/mmhe/sec04/ch050 /ch050e.html http://www.merck.com/mmhe/sec04/ch050 /ch050e.html http://www.merck.com/mmhe/sec04/ch050 /ch050e.html http://www.nhlbi.nih.gov/health/dci/Diseas es/sarc/sar_signsandsymptoms.html http://www.nhlbi.nih.gov/health/dci/Diseas es/sarc/sar_signsandsymptoms.html http://www.nhlbi.nih.gov/health/dci/Diseas es/sarc/sar_signsandsymptoms.html http://www.nhlbi.nih.gov/health/dci/Diseas es/sarc/sar_signsandsymptoms.html http://www.medicinenet.com/sarcoidosis/ar ticle.htm http://www.medicinenet.com/sarcoidosis/ar ticle.htm