Sarcoidosis

Sarcoidosis is a disease involving clusters of inflammatory cells in tissues that form lumps known as granulomas.

The most common localizations of the disease are the lungs, lymph nodes and skin. In more rare cases, the liver, eyes, heart and brain are affected.

Risk factors and causes of development are not currently known. The leading role is played by the effects of environmental factors on a genetically predisposed organism.

Sarcoidosis is registered all over the world, affects both men and women, of all races and ages, but it is noted that the incidence is higher among women.

In some cases, sarcoidosis may be asymptomatic, but in most cases the following clinical symptoms of sarcoidosis are detected:

• common manifestations: increased body temperature, possible long-term preservation of subfebrility, general weakness and fatigue;
• pulmonary manifestations: shortness of breath, pain and discomfort in the chest; dry cough;
• swelling and pain in the ankle joints, in the fingers and toes, less often in other joints;
• skin lesion: erythema nodosum;
• eye damage: soreness, lacrimation, redness, decreased visual acuity, etc.
• cardiac manifestations: discomfort in the heart, palpitations, a feeling of "cardiac arrest";
• there may be an increase in the parotid salivary glands and damage to the facial nerve.

Diagnostic studies to establish the diagnosis of sarcoidosis of the lungs and intra-thoracic lymph nodes:

1. Computed tomography of the chest organs;
2. Ultrasound diagnosis of lymph nodes;
3. Investigation of the function of external respiration: spirogram, bodyplethysmography and diffusion capacity of the lungs;
4. Pulse oximetry at rest and during a 6-minute walking test;
5. A mandatory laboratory diagnostic method is the determination of angiotensin-converting enzyme, as well as C-reactive protein, the level of ionized calcium in the blood and urine.
6. The list of mandatory primary studies also includes a tuberculin test.

The exact diagnosis of sarcoidosis is established on the basis of clinical and radiological data, supported by the identification of specific granulomas during morphological examination.

The following methods can be used to obtain biopsy material:

1. Fibrobronchoscopic: via bronchial forceps biopsy of the lung, classical fine needle puncture and under the control of endoscopic ultrasonography, brush biopsy of the mucous membrane, transbronchial cryobiopsy of the lung.

2. Surgical: transthoracic puncture biopsy under CT control, "open biopsy" of the lung, video thoracoscopy/video-assisted thoracoscopy.

In most cases, sarcoidosis goes away on its own, therefore, if the patient does not experience rapid progression of the disease with impaired and reduced functioning of the lungs, heart and other systems, it is preferable to choose the tactics of active observation.

All patients with sarcoidosis are shown lifestyle modification with mandatory feasible physical activity, avoiding prolonged exposure to the open sun (do not sunbathe), physiotherapy with electromagnetic fields, heat therapy, taking interferon preparations, interferogenesis inducers and other immune stimulants.

Specific drug treatment is used strictly according to the indications and prescription of the doctor. The main groups of drugs are corticosteroids and cytostatics.

In the MCSC named after A.S.Loginov, diagnosis and treatment of pulmonary sarcoidosis is carried out by joint efforts of pulmonologists, endoscopists, radiation diagnostics doctors, morphologists.

Do not delay your visit to the specialists of our center. This will help to diagnose in a timely manner and determine further treatment tactics.