Sarcoidosis Essay, Research Paper

Sarcoidosis

ISarcoidosis is an awful disease that is afflicting people worldwide. Although not much is known about what brings the disease about, much medical research has been done to try and help patients cope with their ailments. The term Sarcoidosis is derived from two Latin words, Sarko and Oid . When put together the term means like cutting flesh (www.Sarcoidcenter.com). This term describes exactly how the physical bodies of Sarcoid patients feel.

Sarcoidosis is an inflammatory disease characterized by granulomas (small rounded outgrowths made up of blood vessels, cells and connective tissues) that can produce many different symptoms (www.nsrc-global.net). This disease occurs when the body s immune system overreacts to an outside agent that has yet to be determined (www.pslgroup.com). The inflammation caused by Sarcoidosis involves the lungs, eyes, skin, and other internal organs of its afflicted hosts (www.sarcoidcenter.com). Generally a chronic disease, Sarcoidosis can last anywhere from a few years to a lifetime.

SIn the United States alone, 30 in every 100,000 people of every ethnic group have Sarcoidosis (www.pslgroup.com). Although Sarcoidosis afflicts every ethnic group, studies show that the disease most often occurs in African-Americans than any other race worldwide. Combine that with the fact that Sarcoidosis affects more women than men (www.nsrc-global.net), about 3% of all African-American women risk getting the disease (www.pslgroup.com).

On a worldwide scale, Sarcoidosis is most commonly seen in blonde Scandinavians, redheaded Irish, Japanese, Africans, and West Indians. On the other hand, the disease is extremely rare in the Chinese, Greeks, and Cypriots. It used to be rare in India also, but cases of it are now being seen more frequently there (www.sarcoidcenter.com). These patterns are crucial evidence to support theories that developing Sarcoidosis could be related to the patients genetic heritage.

TAlong with race, Sarcoidosis shows other factors by which it afflicts people. The disease is extremely rare in the children and the elderly (www.sarcoidcenter.com). It is most commonly seen in the bracket of 20 to 40 years of age (www.nsrc-global.net). It is also more commonly seen in healthcare workers and those that live in rural areas (www.pslgroup.com)

The true cause of Sarcoidosis in yet to be found, but there are many theories about what may bring it on. The most common beliefs are based upon that it is an unknown agent in the patients surrounding environment that causes the disease to occur in its victim. This agent could be found naturally or it could be a toxic chemical improperly disposed in the air or in the ground (www.nsrc.net). In some patients, the symptoms are brought out heavily when they come in or near contact with pine trees or pine fertilizers (Bollinger). Research is also being conducted to find evidence that would support theories that Sarcoidosis is cause by genetic factors, immune system defects, or viral/bacterial infections (www.nsrc-global.net).

ISome people living with Sarcoidosis may show severe signs of its symptoms, yet others may appear to be unaffected. Among these many symptoms are lung problems and dry coughs, severe weight loss, chronic fatigue, high fevers, eye problems, and many others. The inflammatory symptoms brought about by Sarcoidosis include Arthritis throughout the body, and many forms of Myositis (www.nsrc-global.net).

Skin related symptoms are also very common and come most often in the form of Erythema Nodosum and Lupus Pernio. Erythema Nodosum is a redness of the skin that is accompanied by botches and the painful swollenness of joints and ligaments (www.nsrc-global.net). It is a symptom that affects most women with Sarcoidosis in the springtime. Lupus Pernio is a troublesome rash that Ldevelops about the nose, face, and ears (www.sarcoidcenter.com).

Pulmonary functions in Sarcoid sufferers may seem to be normal initially, but if it is advanced abnormalities associated with interitial lung disease are found. 50% of all patients in the U.S. have parenchymal lung disease. One of the many reasons Sarcoid patients suffer physically from the disease is that along with restrictive lung diseases, endobronchial granulomas can result in an element of airway obstruction restriction their function to breath (www.meddean.luc.edu). They may also complain of stuffy noses and chronic sinusitis because Sarcoid tissue can block the nasal passages (www.sarcoidcenter.com).

LMany Sarcoid patients have an abnormality of the lymphadenopathy in addition to lung parenchyma. In the U.S. more than 90% of Sarcoid patients have characteristic thoracic lymphadenopathy, a swelling of the lymph nodes. They most common pattern of this lymphadenopathy found in patients is bilateral symmetric hilar and medianstinal lymph node enlargement (www.meddean.luc.edu). Sometimes, but far less than the eyes, lungs, and skin, Sarcoidosis can involve inflammatory complications in the liver, kidneys, heart, brain bone, and salivary glands (www.sarcoidcenter.com).

ODoctors may use various tests to determine which systems of a Sarcoid patient have been affected. These tests include x-rays, electrocardiograms, radioactive tracers, brain scans, and biopsies of the lungs, skin, and liver (www.sarcoidcenter.com). Abnormalities in chest and lung x-rays are often the first indication a doctor looks for when determining the possibility of Sarcoidosis in a patient (www.meddean.luc.edu). The abnormalities that they most commonly look for in these x-rays are enlarged and tender lymph glands (www.nsrc-global.net).

WThe next step doctors will take in determining the possibility of Sarcoidosis after chest and lung x-rays are biopsies (Bollinger). The most frequent tissue biopsied comes from the lungs. The most common technique in performing a biopsy of lung tissue is through a mediastinoscopy because the tissue found in the mediastinum is positive in as many as 95% of Sarcoid patients. Scalene node biopsies are also frequently used to back up mediastinoscopies because that tissue tests positive in about 80% of all Sarcoid patients. NTransbronchial biopsies are also helpful in diagnosing Sarcoidosis because although they are only positive in 65% of patients, they can test positive even if no lung parenchymal abnormalities are seen (www.meddean.luc.edu).

Blood tests are another effective method in diagnosing patients that doctors use to follow up x-rays and biopsies (www.nsrc-global.net). Serum angiotensin converting enzyme abnormalities are detected in the blood when the liver, kidney, and other organs are afflicted by Sarcoid granulomas (www.meddean.luc.edu). The levels of these enzymes are increased in patients with Sarcoidosis. They can show the progress of the disease and the effectiveness of steroid treatments (www.sarcoidcenter.com)

LSkin tests are also another option doctors may use to verify the possibility of Sarcoidosis in their patients (Bollinger). Reactions to antigens introduced into the skin are an expression of delayed hypersensitivity. Loss of this is common in patients afflicted with Sarcoidosis (www.meddean.luc.edu). Kveim-Slitzbach skin tests use specially prepared Sarcoid tissue that is injected into the skin and is read after one month. If the patient has Sarcoidosis, a little lump of Sarcoid tissue will develop on the site of injection. Another common skin test is the Tuberculin Skin test; an injection made into the skin and gives a response within two or three days. If the test shows a big red patch then it suggests that the body is working well, contrary to those afflicted by Sarcoidosis (www.sarcoidcenter.com).

EIn absolute extreme cases where no other conclusion can be made as to what the patient is ailing from, Gallium lung scans, bronchialveolarlavage scans, Thallium heart scans, and an open lung biopsy may be used to determine if the cause of sickness in a patient is in fact Sarcoidosis (www.sarcoidcenter.com). These tests will also never be performed unless requested by the patient and only if the other, more common and safe methods are first used (Bollinger).

GA definitive diagnosis of Sarcoidosis requires the histologic identification of non-caseating granulomas. Radioactive patterns must be considered in conjunction with clinical findings and the histology of biopsied tissue in order to arrive at a diagnosis of Sarcoid. Sarcoidosis can be difficult to differentiate from other diseases, especially chronic infections such as fungal diseases and some types of lymphoma (www.meddean.luc.edu). It can often be mistaken for other diseases such as hepatitis, dermatitis, arthritis, tuberculosis, and asthma (www.pslgroup.com). Patients with Sarcoidosis can have large thoracic lymph nodes and parenchymal lung disease, and yet be asymptomatic (www.meddean.luc.edu).

ANew ways of treating Sarcoidosis are being developed that focus on controlling the immune systems overreaction that brings about most of the symptoms (www.pslgroup.com). Steroids are used most effectively used to treat the disease. Although they strengthen the body, they may result in many side effects. These side effects include excessive weight gain, indigestion, raised blood pressure, diabetes, and loss of calcium in bones (sarcoidcenter.com). The most common recommended steroid for Sarcoid patients is Prednezone. Prednezone is not a cure for Sarcoidosis, but is successful in surpressing many of the symptoms that accompany the disease. Along with the side effects of other steroids, Prednezone can cause severe fatigue, shot nerves, shakiness, and increased water weight (Bollinger).

LOther tested medications are glucorticoids, NSAIDs, salicylates, colchine, and hydroxychlorquine. Medications that are still being tested for Sarcoid treatment include Methotrexate, Azathioprine, and Cyclosporine. Physical therapy is also used in conjunction with medical treatments to help strengthen patients bodies (www.nsrc-global.net).

RSkin symptoms of Sarcoidosis can also be treated and subsided (Bollinger). Erythema Nodosum can eased with the help of painkilling tablets. Lupus Pernio can be camouflaged with cosmetics or Methotrexate, a medication taken once a week. Patients afflicted with skin rashes do not have to worry about giving it to others because it is not contagious at all (www.sarcoidcenter.com)

IThe condition of a patient will actually improve during pregnancy because the body increases production of its own natural steroids. They don t have to worry about the disease afflicting their children because Sarcoidosis can not be contracted through birth. Although patients symptoms return about three months after pregnancy, they show almost no sign of Sarcoidosis during their pregnancy period (www.sarcoidcenter.com).

GSarcoidosis comes in many different forms, some occurring chronically for a lifetime, while others may pass within a few months to a few years. 50% of Sarcoid patients need little or no treatment at all because the disease may soon pass, but the other 50% will have at least some type of permanent organ damage. Although the disease may cause severe complications in patients lives, it is not fatal. Less than 5% of Sarcoid patients die from complications caused by the disease. With treatments, Sarcoid patients can strive to lead very normal and active lives (www.pslgroup.com). Sarcoid patients have even won medals in the Olympics, become Judo champions, and sailed single handedly around the world (www.sarcoidcenter.com). Little is known about this disease, but constant research is being conducted which will hopefully bring about a cure for Sarcoidosis.

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