Sarcoidosis Definition, Reason, Symptoms, Treatment & Prevention
Definition
Sarcoidosis is a disease associated with inflammatory processes and can attack any organ of the human body. This disease is characterized by the presence of granulomas or small lumps filled with inflammatory cells. The organs most commonly affected are the lungs, skin and eyes. This disease was first discovered by a dermatologist named Caesar Boeck in 1899.
This disease can affect people of all races. Sarcoidosis cases are most common in Northern European countries (5–40 cases per 100,000 people). Meanwhile in Japan, there are as many as 1–2 cases per 100,000 people.
Sarcoid can occur at any age, but generally develops before the age of 50 years, with a peak incidence at the age of 20-39 years. Socioeconomic status did not affect the incidence of sarcoidosis, but lower income was associated with more severe presentation of sarcoidosis.
Sarcoidosis Symptom
Sarcoidosis usually gives symptoms on a chest X-ray at routine examination. Systemic symptoms of this disorder are weakness, night sweats and weight loss. Lofgren’s syndrome, with arthritis, erythema nodosum and bilateral hilar adenopathy occurs in 9-34% of patients.
Sarcoidosis can attack all organs, therefore the symptoms also depend on the type of organ involved, such as:
- Heart. Found in 25% of cases of sarcoidosis. In the involvement of the heart will show impaired heart contractions and heart rhythm disturbances.
- Lungs. Patients with pulmonary involvement will show symptoms of coughing, chest discomfort and wheezing. On X-ray examination, various degrees of lung damage can be found, such as infiltrates, and enlarged hilar lymph nodes, to severe damage, such as fibrotic scar tissue, bullae and hilar retraction.
- Eye. Anterior uveitis is the most common manifestation and occurs in up to 65% of patients with ocular involvement.
- Cutaneous sarcoidosis. The appearance of cutaneous sarcoidosis is the presence of raised bumps, papules and plaques on the back and extremities.
Sarcoidosis Reason
There are several causes of sarcoidosis, namely environmental factors and genetic factors. Various studies have concluded that there is a link between sarcoidosis and exposure to irritants such as wood-burning emissions and tree pollen.
In addition, a relationship was also found between the type of work and the occurrence of this disorder, namely people with professions in the navy, or firefighters. Using polymerase chain reaction technology, blood from sarcoidosis sufferers shows the presence of antibodies against mycobacterial antigens.
Familial sarcoidosis was reported in 1923 in two siblings. Patients with family members who suffer from sarcoidosis have a higher risk of suffering from sarcoidosis.
This disease is associated with a class 1 HLA-B8 antigen-specific gene. Because susceptibility to sarcoidosis depends on genetic and environmental factors. Then the identification of the relationship between genetic loci and the environment is necessary.
The development of sarcoidosis is characterized by accumulation of granulomas. Granulomas are collections of macrophages or lumps and epithelial cells surrounded by lymphocytes. In more mature granulomas, fibroblasts and collagen may surround this collection of cells.
Diagnosis
The diagnosis of sarcoidosis can be determined based on the typical clinical appearance in the presence of radiological features and the histological findings of the appropriate tissue.
Taking a tissue biopsy is necessary to support the diagnosis. Biopsy can be done on the organs involved and is the easiest to take. This examination can be done on the skin, lymph nodes, salivary glands and conjunctiva.
On tissue biopsy examination will show the presence of non-caseating epithelioid granuloma. Whereas in patients without obvious lung involvement, a PET 18 FDG examination can be performed to detect involvement of organs in the body.
Sarcoidosis Treatment
Treatment for sarcoidosis depends on the type of organ involved and the severity of the disease. The recommended prednisone dose is prednisone 20–40 mg/day. Treatment response can be evaluated after 1–3 months.
If therapy gives a good response, then the prednisone dose can be reduced by 5-15 mg/day with a planned therapy for 9-12 months. Some treatment options that can be tried are hydroxychloroquine and thalidomide class of drugs.
Prevention
So far, no effective prevention has been found for this disease.