Sarcoidosis disease is also called Besnirer-Boeck disease. The disease occurs when the normal functioning of the immune system interrupts.
Although the main target of sarcoidosis is the lungs, its damage to other organs is also typical. The disease is more common in people of African descent.
It is suspected that sarcoidosis may occur due to a reaction to bacteria and viruses or to inorganic dust. The condition is not contagious.
The fact that some families are more affected causes us to consider whether the disease has a genetic transmission. Symptoms of sarcoidosis vary depending on the organ affected.
Sometimes, it may be asymptomatic. For this reason, the percentage of incidence increases due to randomly performed radiography. In some patients, the disease presents itself with eye manifestations.
It presents with blurred vision, tearing, and photosensitivity.
How Does Sarcoidosis Generally React?
Sarcoidosis gives symptoms to many organs, especially the lungs. It is more common in women than men. The disease is most common between the ages of 20-40.
About 70 percent of patients are 40 or younger. It is also infrequent in young children. An accidental chest x-ray often detects sarcoidosis.
Sarcoidosis usually occurs in non-smokers. The cause of sarcoidosis is unknown, although it has been present for over a hundred years.
The disease occurs similarly to when the immune system reacts differently to the tuberculosis bacteria or other bacteria and viruses.
A disease presentation similar to sarcoidosis is seen in the workers working in beryllium mines in the weapons and aircraft industry. Sarcoidosis is not a contagious disease.
Genetics unknown. However, the disease is more common in some families.
Sarcoidosis is most common in Scandinavian countries. It is more common in western European regions than in eastern regions.
Sarcoidosis is an Insidious Disease
It may start suddenly or may prefer an insidious way. Most of the time, patients do not realize their disease.
An incidental chest X-ray often recognizes it, and this is quite common. Sarcoidosis has very interesting features.
The disease usually occurs in the months of April-May-June in most people. Sarcoidosis disease can attach to any organ in the body, but the most affected organ is usually the lungs.
Inflammation in the lung tissue and growth in the lymph nodes are detected. The main symptoms are dry cough and shortness of breath with the potential to progress.
Purplish spots around the lips, cheeks, and nose characterize the typical cutaneous manifestation of sarcoidosis. In some people, red and painful swellings occur on the front of the legs.
Symptoms such as fever and joint pain may also manifest. The most common symptoms are enlarged lymph nodes and splenomegaly. Although these symptoms may initially resemble cancer, lymphoma, or tuberculosis, the signs point to sarcoidosis.
Blurred vision, sensitivity to light, and tearing in the eyes manifest in sarcoidosis. These symptoms are common in young women and are the first signs of the disease.
Although rare, sarcoidosis can threaten the joints, bones, kidneys, and heart. Chest X-rays and tomography are essential for the diagnosis of the disease.
In some patients, a lung biopsy may also be required.
High levels of ACE enzyme and calcium in the blood or increased urinary calcium excretion are signs and symptoms of sarcoidosis.
What Are the Complications of Sarcoidosis?
- Honeycomb lung
- Eye problems
- Dry mouth
- Facial paralysis
- Hearing loss
- Increase in blood calcium level
Patients may remain completely asymptomatic for a long time. In sarcoidosis, the affected tissues form microscopic clumps of cells.
Lymph nodes are in the first place with 90% involvement. The liver is between sixty and ninety percent, the eyes are twenty-five percent, the heart is five percent, the skeleton is between twenty-five and fifty percent, the skin is twenty-five percent, and the bone marrow is between fifteen and forty percent.
Findings vary by organ. When lung involvement occurs, fatigue and exertional dyspnea are common, while chest pain and hemoptysis are less common.
The main clinical findings are:
- Peripheral neuropathy in the face.
- Increased blood calcium level.
- Kyeim test.
- Liver dysfunction.
- Erythema nodosum.
- Lupus pernio on the skin.
Pulmonary function tests may be normal in lung involvement, but there is usually a restrictive pattern.
Pulmonary infiltration with mediastinal and hilar lymphadenopathy is seen on chest X-ray.
Treatment of Sarcoidosis
Sarcoidosis treatment aims to prevent damage due to progression, treat symptomatic corrections, and suppress disease activity.
Standard treatment protocols are present. These are corticosteroids, antimalarials, and methotrexate.
Alternative treatment approaches can be preferred depending on the response to standard treatments and side effects.
The patient and doctor should be in a treatment program for 12 months. In this program, the doctor follows the patient for 12 months, and there is no need for treatment if there is no progression.
Medications suppress the immune system's responses. Thus, the symptoms of the disease improve. Corticosteroids and immunosuppressants suppress the immune system and produce fewer antibodies.
Prednisone is a steroid that gives successful results in the treatment of patients. However, it has a few side effects.
These side effects are osteoporosis, cataracts, diabetes, hypertension and myopathy.
In other words, despite no definite treatment for the disease, cortisone is a solution. The treatment duration can be 6-12 months by decreasing the dose of cortisone over time.
If there is any evidence of eye, nervous system, and heart involvement, cortisone treatment becomes essential.
Enlargement of the lymph nodes does not require cortisone treatment. Still, treatment may be necessary according to the patient's respiratory system functions and symptoms, such as cough and shortness of breath.
In cases where there is no cortisone response or it is contraindicated to use, other drugs that suppress the immune system are preferred.
Sarcoidosis is not a disease to be feared; but sometimes drugs may not cure it.
All sarcoidosis patients should come to check-ups at regular intervals. Not all patients require treatment.
In the early diagnosis of sarcoidosis, the probability of spontaneous recovery of patients is relatively high. For this reason, 30 percent to 70 percent of patients may not even require treatment.
The progression of symptoms such as shortness of breath and cough evaluates the treatment's effectiveness.
In cases where the patients do not respond to cortisone, other types of immune suppressants are recommended.
