Sarcoidosis Disease - Information, Defination, causes of Sarcoidosis
Sarcoidosis is a systemic disease characterized by a noncaseating granulomatous reaction of unknown origin. Our present concept of this syndrome has evolved from the early descriptions by Hutchinson, Besnier, and Boeck, as well as by Schaumann. Symptoms and signs depend on the organs affected, most frequently the lymph nodes, lungs, liver, skin, and eyes. Muscle, spleen, bones, parotid glands, central nervous system, peripheral nerves, blood vessels, endocrine glands, and almost any other tissue, including the joints, may also be involved. Although generally a chronic disease, the onset of sarcoidosis can be acute, with hilar adenopathy, erythema nodosum, fever, and articular manifestations. This acute form is often termed Lofgren syndrome
Diagnosis of Sarcoidosis
The diagnosis of sarcoidosis is established by the demonstration of typical noncaseating granulomas in the absence of other identifiable causes of such granulomas. Impaired delayed hypersensitivity on skin testing is characteristic but not invariable. Impaired tuberculin sensitivity after bacille Calmette-Guérin (BCG) vaccination may persist even after apparent recovery from sarcoidosis.
Diagnostic features of sarcoidosis:
Noncaseating granulomas on biopsy: one must exclude other causes of granulomas.
Hilar and right paratracheal adenopathy in 90% of patients.
Skin lesions, uveitis, or involvement of almost any tissue.
Onset most often in third and fourth decades of life, but cases reported at all ages.
Impaired delayed hypersensitivity in 85% of patients.
Increased angiotensin-converting enzyme levels in about 80% of patients.
Hypercalciuria in most patients: hypercalcemia in some.
More Information on Sarcoidosis Disease
In acute sarcoidosis with hilar adenopathy, fever, and erythema nodosum, up to 89% of patients have articular symptoms, and 69% and 63% had articular or periarticular swelling, respectively, in the series of Lofgren. Ankle and knee joints are most frequently involved in acute sarcoidosis. Most other joints are occasionally involved. Heel pad pain is common; monarthritis is unusual.