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Sarcoidosis
Classification and external resources
.
Pulmonary sarcoidosis with asteroid bodies.^ Sarcoidosis, a systemic disorder of unknown cause, is characterised by the presence of non-caseating epithelioid granulomata, with Langerhan's giant cells, Schaumann and asteroid bodies 1 .
  • Final Diagnosis -- Case 100 17 January 2010 12:25 UTC path.upmc.edu [Source type: Academic]

^ Progression of pulmonary sarcoidosis is measured by the degree of lung involvement which may not affect the body in consecutive order.

^ Schaumann bodies, birefringent calcium oxalate crystals , and asteroid bodies , although not specific for sarcoidosis, are frequent findings in the giant cells [ 5 ].

H&E stain.
ICD-10 D86.
ICD-9 135
OMIM 181000
DiseasesDB 11797
MedlinePlus 000076
eMedicine med/2063
MeSH D012507
.Sarcoidosis (sarc = flesh, -oid = like, -osis = a process), also called sarcoid or Besnier-Boeck disease, is a multisystem granulomatous inflammatory disease[1] characterized by non-caseating granulomas (small inflammatory nodules).^ Sarcoidosis was originally called Hutchinson's disease or Boeck's disease.
  • Sarcoidosis Causes, Symptoms, Diagnosis and Treatment Information on MedicineNet.com 17 January 2010 12:25 UTC www.medicinenet.com [Source type: FILTERED WITH BAYES]
  • What is Sarcoidosis? 17 January 2010 12:25 UTC www.medhelp.org [Source type: Academic]
  • Sarcoidosis 17 January 2010 12:25 UTC www.vaccinetruth.org [Source type: Academic]

^ The disease is characterized by the presence of granulomas, small areas of inflamed cells.
  • Sarcoidosis 17 January 2010 12:25 UTC www.health-doctor.org [Source type: FILTERED WITH BAYES]
  • Sarcoidosis — University of Louisville 17 January 2010 12:25 UTC louisville.edu [Source type: Academic]

^ BACKGROUND: Sarcoidosis is a multisystem inflammatory disease of unknown cause.
  • Echocardiography 17 January 2010 12:25 UTC www2.umdnj.edu [Source type: Academic]

.The cause of the disease is still unknown.^ Sarcoidosis: Sarcoidosis is a disease of unknown cause in which ...
  • Sarcoidosis: Sarcoidosis is a disease of unknown cause in which ... 17 January 2010 12:25 UTC www.henryfordhealth.org [Source type: Academic]

^ The cause of the disease is still unknown.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]
  • Sarcoidosis Disability Claims Help - Information - Representation 17 January 2010 12:25 UTC disability-claims.net [Source type: FILTERED WITH BAYES]
  • Sarcoidosis Clinical Trials 17 January 2010 12:25 UTC www.clinicalconnection.com [Source type: Academic]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ The cause of sarcoidosis is still unknown.
  • Sarcoidosis : Canadian Lung Association 17 January 2010 12:25 UTC www.lung.ca [Source type: FILTERED WITH BAYES]
  • The Lung Association of Saskatchewan 17 January 2010 12:25 UTC www.sk.lung.ca [Source type: Original source]

.Granulomas most often appear in the lungs or the lymph nodes, but virtually any organ can be affected.^ Sarcoidosis can appear in almost any body organ, but most often starts in the lungs or lymph nodes.
  • Sarcoidosis definition - Arthritis and Arthritic Conditions, Medications, Symptoms, and Treatment on MedicineNet.com 17 January 2010 12:25 UTC www.medterms.com [Source type: FILTERED WITH BAYES]

^ It is usually found on the lungs, but can appear on most any organ.
  • Sarcoidosis - Symptoms, Treatment and Living With the Condition - Associated Content - associatedcontent.com 17 January 2010 12:25 UTC www.associatedcontent.com [Source type: General]

^ The hands and feet are most often affected.
  • Sarcoidosis -- familydoctor.org 17 January 2010 12:25 UTC familydoctor.org [Source type: Original source]

.Symptoms usually appear gradually but can occasionally appear suddenly.^ Symptoms usually appear gradually but can occasionally appear suddenly.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ Symptoms can occasionally appear suddenly but more often than not appear gradually.
  • Sarcoidosis 17 January 2010 12:25 UTC www.night-sweats.net [Source type: Academic]
  • Sarcoidosis Support Group - DailyStrength 17 January 2010 12:25 UTC www.dailystrength.org [Source type: General]
  • Sarcoidosis Pulmonology 17 January 2010 12:25 UTC www.lumrix.net [Source type: Academic]
  • Sarkoidose - Info - Sarcoidosis (English-Content) 17 January 2010 12:25 UTC sarkoidose.solutix.de [Source type: Academic]

^ Symptoms can appear suddenly, and then disappear.
  • What is Sarcoidosis? 17 January 2010 12:25 UTC www.medhelp.org [Source type: Academic]

.The clinical course generally varies and ranges from asymptomatic disease to a debilitating chronic condition that may lead to death.^ The clinical course varies and ranges from asymptomatic disease that resolves spontaneously to a debilitating chronic condition that may lead to death.

^ The course of the disease varies from person to person.
  • Sarcoidosis - MayoClinic.com 17 January 2010 12:25 UTC www.mayoclinic.com [Source type: General]
  • MayoClinic.com Health Library - Sarcoidosis 17 January 2010 12:25 UTC www.riversideonline.com [Source type: General]

^ The clinical course varies and ranges from asymptomatic disease to a debilitating chronic condition that may lead to death.
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

Contents

Epidemiology

.Sarcoidosis most commonly affects young adults of both sexes, although studies have reported more cases in females.^ The lungs are most commonly involved in sarcoidosis.
  • Sarcoidosis | Health | Patient UK 17 January 2010 12:25 UTC www.patient.co.uk [Source type: General]

^ Sarcoidosis-a short review with a case report.
  • Cutaneous sarcoidosis without systemic involvement Singh G, Sangolli P, Dash K, Grove - Indian J Dermatol Venereol Leprol 17 January 2010 12:25 UTC www.ijdvl.com [Source type: Academic]

^ Sarcoidosis commonly affects young and middle-aged adults.
  • USPharmacist.com > Sarcoidosis 17 January 2010 12:25 UTC www.uspharmacist.com [Source type: Academic]

Incidence is highest for individuals younger than 40 and peaks in the age-group from 20 to 29 years; a second peak is observed for women over 50.[2][3]
.Sarcoidosis occurs throughout the world in all races with an average incidence of 16.5/100,000 in men and 19/100,000 in women.^ It affects men and women of all ages and races worldwide.
  • Sarcoidosis: MedlinePlus 17 January 2010 12:25 UTC www.nlm.nih.gov [Source type: Academic]

^ The disease occurs throughout the world.

^ Sarcoidosis affects men and women of all ages and races worldwide.
  • LUNG DISORDERS - Sarcoidosis 17 January 2010 12:25 UTC www.medic8.com [Source type: General]
  • Sarcoidosis - Vermont Department of Health 17 January 2010 12:25 UTC www.healthvermont.gov [Source type: FILTERED WITH BAYES]
  • About Sarcoidosis 17 January 2010 12:25 UTC www.sfotexas.org [Source type: General]

.The disease is most prevalent in Northern European countries, and the highest annual incidence of 60/100,000 is found in Sweden and Iceland.^ There is also an increased incidence in northern European countries: 60 per 100,000 people in Sweden and Iceland.

^ The disease is most prevalent in Northern European countries, and the highest annual incidence of 60 per 100,000 is found in Sweden and Iceland.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]
  • Sarcoidosis Clinical Trials 17 January 2010 12:25 UTC www.clinicalconnection.com [Source type: Academic]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ This is a worldwide disease with the lowest prevalence in the Far East and the highest in Sweden.
  • MySpace - Sarcoidosis Awareness - 45 - Male - CELEBRATION, Florida - myspace.com/sarcoid 17 January 2010 12:25 UTC www.myspace.com [Source type: FILTERED WITH BAYES]

.In the United States, sarcoidosis is more common in people of African descent than Caucasians, with annual incidence reported as 35.5 and 10.9/100,000, respectively.^ The prevalence in the United States is 20-50/100,000 population.
  • MySpace - Sarcoidosis Awareness - 45 - Male - CELEBRATION, Florida - myspace.com/sarcoid 17 January 2010 12:25 UTC www.myspace.com [Source type: FILTERED WITH BAYES]

^ In the United States , the incidence of sarcoidosis is less than 60 per 100,000 population, with African Americans more likely to suffer the ravages of the disease than whites.

^ The lifetime risk for sarcoidosis in the United States is 0.85% for Caucasians and 2.4% for African Americans.
  • USPharmacist.com > Sarcoidosis 17 January 2010 12:25 UTC www.uspharmacist.com [Source type: Academic]

[4] .Sarcoidosis is less commonly reported in South America, Spain, India, Canada, and Philippines.^ Sarcoidosis is less commonly reported in South America, Spain and India.
  • Sarcoidosis Clinical Trials 17 January 2010 12:25 UTC www.clinicalconnection.com [Source type: Academic]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ Sarcoidosis is less commonly reported in South America, Spain and India, Canada and Philippines.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ Thus, although POF may have a corticosteroid-sparing effect in pulmonary sarcoidosis, with concentrations of drug used in this study, gastrointestinal side effects were commonly reported.
  • http://www.marshallprotocol.com/forum37/3094.html 17 January 2010 12:25 UTC www.marshallprotocol.com [Source type: FILTERED WITH BAYES]

.The differing incidence across the world may be at least partially attributable to the lack of screening programs in certain regions of the world and the overshadowing presence of other granulomatous diseases, such as tuberculosis, that may interfere with the diagnosis of sarcoidosis where they are prevalent.^ Other countries report a lower occurrence, which may be due to a lack of screening programs or the presence of other granulomatous diseases such as tuberculosis.

^ The differing incidence across the world may be at least partially attributable to the lack of screening programs in certain regions of the world and the overshadowing presence of other granulolomatous diseases such as tuberculosis , that may interfere with the diagnosis of sarcoidosis where they are prevalent.

^ Reynolds HY. Other granulomatous diseases - how can they help with understanding sarcoidosis?

[2] .There may also be differences in the severity of the disease between people of different ethnicity.^ But there are a lot of differences among people.
  • LUNG DISORDERS - Sarcoidosis 17 January 2010 12:25 UTC www.medic8.com [Source type: General]
  • Sarcoidosis 17 January 2010 12:25 UTC www.metrohealth.org [Source type: General]
  • Sarcoidosis Diagnosis 17 January 2010 12:25 UTC www.web-books.com [Source type: General]

^ Disease severity can vary by race or ethnicity.
  • FSR - Sarcoidosis Disease Facts & Statistics 17 January 2010 12:25 UTC www.stopsarcoidosis.org [Source type: FILTERED WITH BAYES]

^ There may also be racial differences in the severity of the disease.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]
  • Sarcoidosis Clinical Trials 17 January 2010 12:25 UTC www.clinicalconnection.com [Source type: Academic]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

.Several studies suggest that the presentation in people of African origin may be more severe and disseminated than for Caucasians, who are more likely to have asymptomatic disease.^ The disease is 10 to 17 times more common in African-Americans than in Caucasians.
  • Sarcoidosis Symptoms, Causes and Diagnosis - from WebMD 17 January 2010 12:25 UTC www.webmd.com [Source type: General]
  • What is Sarcoidosis 17 January 2010 12:25 UTC my.clevelandclinic.org [Source type: Academic]
  • EmphyCorp, Inc. - Sarcoidosis 17 January 2010 12:25 UTC emphycorp.com [Source type: Academic]

^ Several studies suggest that the presentation in people of African origin may be more severe and disseminated than for Caucasians, who are more likely to have asymptomatic disease.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ This is less frequent and usually less severe in Caucasians than in African-Americans.
  • Sarcoidosis: clinical update -- Costabel 18 (32 Supplement): 56S -- European Respiratory Journal 17 January 2010 12:25 UTC erj.ersjournals.com [Source type: Academic]

[5]
.Manifestation appears to be slightly different according to race and sex.^ Hypersensitivity to environmental factors Genetics Extreme immune response to infection The incidence varies widely according to race and sex.
  • Find Health Information - Trinity Regional Health System 17 January 2010 12:25 UTC www.trinityqc.com [Source type: FILTERED WITH BAYES]
  • Sarcoidosis: Sarcoidosis is a disease of unknown cause in which ... 17 January 2010 12:25 UTC www.henryfordhealth.org [Source type: Academic]
  • Sarcoidosis - Edward Hospital, Naperville IL Area 17 January 2010 12:25 UTC www.edward.org [Source type: Academic]
  • Sarcoidosis 17 January 2010 12:25 UTC www.clarian.org [Source type: Academic]
  • Alegent; Omaha - Sarcoidosis. Sarcoidosis is a disease of unknown cause in which... 17 January 2010 12:25 UTC www.alegent.com [Source type: Academic]
  • Sarcoidosis; Baltimore, Maryland MD 17 January 2010 12:25 UTC www.goodsam-md.org [Source type: Academic]
  • Sarcoidosis - Symptoms, Diagnosis, Treatment of Sarcoidosis - NY Times Health Information 17 January 2010 12:25 UTC health.nytimes.com [Source type: News]
  • Sarcoidosis, Health Information, UW Health, University of Wisconsin Hospital, Madison 17 January 2010 12:25 UTC apps.uwhealth.org [Source type: Academic]
  • Sarcoidosis 17 January 2010 12:25 UTC www.bcbswny.com [Source type: Academic]
  • Health A-Z 17 January 2010 12:25 UTC www.stlukes.org [Source type: FILTERED WITH BAYES]
  • Smart Tanning 17 January 2010 12:25 UTC drtindall.org [Source type: FILTERED WITH BAYES]
  • Health Library 17 January 2010 12:25 UTC www.floridahospital.com [Source type: Academic]
  • Sarcoidosis 17 January 2010 12:25 UTC www.skagitvalleyhospital.org [Source type: Academic]

^ It is a ubiquitous disease with incidence (varying according to age, sex, race and geographic origin) estimated at around 16.5/100,000 in men and 19/100,000 in women.
  • Sarcoidosis | Doctor | Patient UK 17 January 2010 12:25 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

^ It is an ubiquitous disease with incidence (varying according to age, sex, race and geographic origin) estimated at around 16.5/100,000 in men and 19/100,000 in women.
  • Orphanet Journal of Rare Diseases | Full text | Sarcoidosis 17 January 2010 12:25 UTC www.ojrd.com [Source type: Academic]

.Erythema nodosum is far more common in men than in women and in Caucasians than in other races.^ Cardiac involvement is more common in Japan than in other countries.

^ Erythema nodosum is seen predominantly in women and arthritis is more common in men.

^ It is more common in African Americans than Caucasians.
  • Find Health Information - Trinity Regional Health System 17 January 2010 12:25 UTC www.trinityqc.com [Source type: FILTERED WITH BAYES]
  • Sarcoidosis: Sarcoidosis is a disease of unknown cause in which ... 17 January 2010 12:25 UTC www.henryfordhealth.org [Source type: Academic]
  • Sarcoidosis - Edward Hospital, Naperville IL Area 17 January 2010 12:25 UTC www.edward.org [Source type: Academic]
  • Sarcoidosis 17 January 2010 12:25 UTC www.clarian.org [Source type: Academic]
  • Alegent; Omaha - Sarcoidosis. Sarcoidosis is a disease of unknown cause in which... 17 January 2010 12:25 UTC www.alegent.com [Source type: Academic]
  • Sarcoidosis; Baltimore, Maryland MD 17 January 2010 12:25 UTC www.goodsam-md.org [Source type: Academic]
  • Sarcoidosis - Symptoms, Diagnosis, Treatment of Sarcoidosis - NY Times Health Information 17 January 2010 12:25 UTC health.nytimes.com [Source type: News]
  • Sarcoidosis, Health Information, UW Health, University of Wisconsin Hospital, Madison 17 January 2010 12:25 UTC apps.uwhealth.org [Source type: Academic]
  • Sarcoidosis 17 January 2010 12:25 UTC www.bcbswny.com [Source type: Academic]
  • Sarcoidosis 17 January 2010 12:25 UTC www.drexelmed.edu [Source type: Academic]
  • Health A-Z 17 January 2010 12:25 UTC www.stlukes.org [Source type: FILTERED WITH BAYES]
  • Smart Tanning 17 January 2010 12:25 UTC drtindall.org [Source type: FILTERED WITH BAYES]
  • Health Library 17 January 2010 12:25 UTC www.floridahospital.com [Source type: Academic]
  • Sarcoidosis 17 January 2010 12:25 UTC www.skagitvalleyhospital.org [Source type: Academic]

.In Japanese patients, ophthalmologic and cardiac involvement are more common than in other races.^ Ocular involvement more common among black Americans and Japanese .
  • Sarcoidosis: Pulmonary Disorders: Merck Manual Professional 17 January 2010 12:25 UTC www.merck.com [Source type: Academic]

^ Only two patients (8%) had a cardiac involvement.
  • Echocardiography 17 January 2010 12:25 UTC www2.umdnj.edu [Source type: Academic]

^ Cardiac death was much more frequent in Japanese patients.
  • Echocardiography 17 January 2010 12:25 UTC www2.umdnj.edu [Source type: Academic]

[3]
.Sarcoidosis is one of the few pulmonary diseases with a higher prevalence in non-smokers.^ Pulmonary sarcoidosis is one of the new diseases of our lifetime.
  • ISPUB - Pulmonary Sarcoidosis and Traditional Chinese Medicine 17 January 2010 12:25 UTC www.ispub.com [Source type: Academic]

^ Sarcoidosis has been one of the few remaining "mystery diseases" of modern medicine.
  • Remission in Sarcoidosis - Overview 17 January 2010 12:25 UTC www.sarcinfo.com [Source type: Academic]

^ Environmental Factors - sarcoidosis is more prevalent in non-smokers than smokers.
  • What is Sarcoidosis 17 January 2010 12:25 UTC www.squidoo.com [Source type: FILTERED WITH BAYES]

Types

Sarcoidosis may be divided into the following types:[6]:708-11

Signs and symptoms

.
Signs and symptoms of sarcoidosis.
^ What are the signs and symptoms of sarcoidosis?
  • Sarcoidosis. DermNet NZ 17 January 2010 12:25 UTC dermnetnz.org [Source type: Academic]
  • Health topics - Sarcoidosis (General Information) 17 January 2010 12:25 UTC www.allina.com [Source type: General]

^ Other signs and symptoms of sarcoidosis include: .
  • dreddyclinic.com - Sarcoidosis 17 January 2010 12:25 UTC www.dreddyclinic.com [Source type: Academic]

^ Signs and symptoms when sarcoidosis affects the lungs: .
  • Sarcoidosis : Canadian Lung Association 17 January 2010 12:25 UTC www.lung.ca [Source type: FILTERED WITH BAYES]

[7]
.Sarcoidosis is a systemic disease that can affect any organ.^ The disease can affect any part of the nervous system.

^ Sarcoidosis can affect any organ in your body.
  • What is sarcoidosis? 17 January 2010 12:25 UTC www.nhlbi.nih.gov [Source type: FILTERED WITH BAYES]

^ Mouth Sarcoidosis can affect any organ, and the mouth is not exempt.
  • http://www.marshallprotocol.com/forum37/3094.html 17 January 2010 12:25 UTC www.marshallprotocol.com [Source type: FILTERED WITH BAYES]

.Common symptoms are vague, such as fatigue unchanged by sleep, lack of energy, weight loss, aches and pains, arthritis, dry eyes, swelling of the knees, blurry vision, shortness of breath, a dry hacking cough or skin lesions.^ My symptoms include chronic coughing, shortness of breath, chronic fatigue & joint pain in my hands and wrists.
  • Sarcoidosis Awareness - The Petition Site 17 January 2010 12:25 UTC www.thepetitionsite.com [Source type: General]

^ Shortness of breath Cough Skin rashes.
  • Sarcoidosis - Causes, Symptoms and Treatment 17 January 2010 12:25 UTC www.cosmeticsdiary.com [Source type: Academic]

^ Soreness of the eyes, and pain and swelling of the ankles.
  • Sarcoidosis - Causes, Symptoms and Treatment 17 January 2010 12:25 UTC www.health-disease.org [Source type: Academic]

.Sarcoidosis and cancer may mimic one another, making the distinction difficult.^ Sarcoidosis may be difficult to diagnose.
  • SARCOIDOSIS: Australian Lung Foundation selected Information sheets: NEVDGP 17 January 2010 12:25 UTC www.nevdgp.org.au [Source type: FILTERED WITH BAYES]

^ Sarcoidosis is a rare disease (in the region of 30 per 100,000 in the USA) that may affect one or more organs.
  • SILA | The Sarcoidosis Charity 17 January 2010 12:25 UTC www.shelford.net [Source type: FILTERED WITH BAYES]

^ The relatively innocuous presentation of these findings can make the radiographic diagnosis of skeletal sarcoidosis difficult and probably results in a substantial underdiagnosis of the disease.
  • FDG Positron Emission Tomography of Bone Involvement in Sarcoidosis -- Aberg et al. 182 (4): 975 -- American Journal of Roentgenology 17 January 2010 12:25 UTC www.ajronline.org [Source type: Academic]

[8] .The cutaneous symptoms vary, and range from rashes and noduli (small bumps) to erythema nodosum or lupus pernio.^ The cutaneous symptoms vary, and range from rashes and noduli (small bumps) to erythema nodosum or lupus pernio .
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ Skin lesions Erythema nodosum Lupus pernio Other lesions .
  • Sarcoidosis: A Primary Care Review - December 1998 - American Academy ofFamily Physicians 17 January 2010 12:25 UTC www.aafp.org [Source type: Academic]

^ The cutaneous symptoms vary, and range from rashes and noduli (small bumps) to erythema nodosum or lupus pernio.Renal, liver (including portal hypertension ), heart or brain involvement may cause further symptoms and altered functioning.
  • Sarcoidosis - Causes, Symptoms and Treatment 17 January 2010 12:25 UTC www.cosmeticsdiary.com [Source type: Academic]

It is often asymptomatic.
.The combination of erythema nodosum, bilateral hilar lymphadenopathy and arthralgia is called Löfgren syndrome.^ Löfgren syndrome Symptoms consist of fever, bilateral hilar lymphadenopathy (BHL), and polyarthralgias.

^ CLOSE WINDOW ] Bilateral hilar lymphadenopathy.

^ The combination of erythema nodosum, bilateral hilar lymphadenopathy and arthralgia is called Lofgren syndrome.

.This syndrome has a relatively good prognosis.^ This syndrome has a relatively good prognosis.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]
  • Sarcoidosis Support Group - DailyStrength 17 January 2010 12:25 UTC www.dailystrength.org [Source type: General]
  • Sarcoidosis Clinical Trials 17 January 2010 12:25 UTC www.clinicalconnection.com [Source type: Academic]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ Lofgren's syndrome is associated with a relatively good prognosis and consists of fever, enlarged lymph nodes, arthritis (especially in ankles and more common in men and whites), or erythema nodosum.

.Renal, liver (including portal hypertension), heart[9] or brain involvement may cause further symptoms and altered functioning.^ The cutaneous symptoms vary, and range from rashes and noduli (small bumps) to erythema nodosum or lupus pernio.Renal, liver (including portal hypertension ), heart or brain involvement may cause further symptoms and altered functioning.
  • Sarcoidosis - Causes, Symptoms and Treatment 17 January 2010 12:25 UTC www.cosmeticsdiary.com [Source type: Academic]

^ Renal, liver, heart or brain involvement may cause further symptoms and altered functioning.
  • Sarcoidosis 17 January 2010 12:25 UTC www.night-sweats.net [Source type: Academic]
  • Sarcoidosis Support Group - DailyStrength 17 January 2010 12:25 UTC www.dailystrength.org [Source type: General]
  • Sarcoidosis Pulmonology 17 January 2010 12:25 UTC www.lumrix.net [Source type: Academic]

^ Sarcoidosis may also cause more general symptoms, including: .
  • LUNG DISORDERS - Sarcoidosis 17 January 2010 12:25 UTC www.medic8.com [Source type: General]

.Sarcoidosis affecting the brain or nerves is known as neurosarcoidosis.^ Sarcoidosis affecting the brain or nerves is known as neurosarcoidosis.

^ Sarcoidosis can also affect your spleen, brain, nerves, and heart.
  • Sarcoidosis 17 January 2010 12:25 UTC diseases.emedtv.com [Source type: FILTERED WITH BAYES]
  • LUNG DISORDERS - Sarcoidosis 17 January 2010 12:25 UTC www.medic8.com [Source type: General]

^ Sarcoidosis affecting the brain or nerves is known as neurosarcoidosis .
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]
  • Sarcoidosis Pulmonology 17 January 2010 12:25 UTC www.lumrix.net [Source type: Academic]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

.Although cardiac involvement is present in 20% to 30% of patients with sarcoidosis, only about 5% patients with systemic sarcoidosis are symptomatic.^ Only about 12 percent of patients present at stage 3.
  • Sarcoidosis: A Primary Care Review - December 1998 - American Academy ofFamily Physicians 17 January 2010 12:25 UTC www.aafp.org [Source type: Academic]

^ Cardiac involvement occurred in 15 patients.
  • Echocardiography 17 January 2010 12:25 UTC www2.umdnj.edu [Source type: Academic]

^ The skin is affected in about 20% of sarcoidosis patients.

[10]
.The presentation of cardiac sarcoidosis can range from asymptomatic conduction abnormalities to fatal ventricular arrhythmia.^ Abeler V. Sarcoidosis of the cardiac conducting system.
  • Fire Fighter Fatality Investigation Report F2003-08 | CDC/NIOSH 17 January 2010 12:25 UTC www.cdc.gov [Source type: Academic]

^ Clinicians should consider the possibility of sarcoid heart disease in the evaluation of an otherwise healthy young or middle-aged person with cardiac symptoms, or in a patient with known sarcoidosis who develops arrhythmias, conduction disease, or heart failure.

^ Manifestations include atrial and ventricular arrhythmias, conduction abnormalities, congestive cardiac failure, pericarditis, and sudden death.
  • Echocardiography 17 January 2010 12:25 UTC www2.umdnj.edu [Source type: Academic]

[11] .Myocardial sarcoidosis can be a rare cause of sudden cardiac death.^ PH as a consequence of undiagnosed sarcoidosis has also been reported as a cause of sudden death.
  • Sarcoidosis and Pulmonary Hypertension: Pulmonary Hypertension 17 January 2010 12:25 UTC cme.medscape.com [Source type: Academic]

^ In rare cases sarcoidosis can result in death.
  • Sarcoidosis - information, symptoms and treatment 17 January 2010 12:25 UTC hcd2.bupa.co.uk [Source type: General]

^ Myocardial sarcoidosis as a rare cause of sudden cardiac death.

[12][13]
.Manifestations in the eye include uveitis, uveoparotitis, and retinal inflammation, which may result in loss of visual acuity or blindness.^ Uveitis: Inflammation of the eye.

^ Eyes (uveitis common, may lead to blindness) .
  • Sarcoidosis - July 15, 2004 - American Family Physician 17 January 2010 12:25 UTC www.aafp.org [Source type: Academic]

^ Manifestations in the eye include uveitis , uveoparotitis , and retinal inflammation, which may result in loss of visual acuity or blindness.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

.The combination of anterior uveitis, parotitis, VII cranial nerve paralysis and fever is called uveoparotid fever, and is associated with Heerfordt-Waldenstrom syndrome.^ The Heerfordt-Waldenstrom syndrome describes individuals with fever, parotid enlargement, anterior uveitis, and facial nerve palsy.

^ The combination of anterior uveitis, parotitisand fever is called Heerfordt-Waldenstrom syndrome.
  • Sarcoidosis Pulmonology 17 January 2010 12:25 UTC www.lumrix.net [Source type: Academic]

^ A variant of sarcoid called Heerfordt's syndrome (uveoparotid fever) is characterized by fever, parotid enlargement, and uveitis.
  • Baylor Health Care System: Sarcoidosis 17 January 2010 12:25 UTC www.baylorhealth.edu [Source type: Academic]

(D86.8)
.Sarcoidosis of the scalp presents with diffuse or patchy hair loss.^ B. — 34-year-old woman with sarcoidosis who presented with malaise, anorexia, weight loss, fever, and night sweats.
  • Imaging Manifestations of Abdominal Sarcoidosis -- Warshauer and Lee 182 (1): 15 -- American Journal of Roentgenology 17 January 2010 12:25 UTC www.ajronline.org [Source type: Academic]

^ When sarcoidosis presents with the sudden onset of weight loss and malaise, the expectation is a relatively short limited course.

^ A. — 34-year-old woman with sarcoidosis who presented with malaise, anorexia, weight loss, fever, and night sweats.
  • Imaging Manifestations of Abdominal Sarcoidosis -- Warshauer and Lee 182 (1): 15 -- American Journal of Roentgenology 17 January 2010 12:25 UTC www.ajronline.org [Source type: Academic]

[6]:762
.Sarcoidosis is a possible cause of Bell's palsy.^ Possible causes of sarcoidosis include: .
  • Sarcoidosis Medical Information 17 January 2010 12:25 UTC www.drugs.com [Source type: Academic]
  • Sarcoidosis - MMCI 17 January 2010 12:25 UTC mmci2.adam.com [Source type: FILTERED WITH BAYES]
  • Sarcoidosis :: BestHealth.com :: Wake Forest University Baptist Medical Center 17 January 2010 12:25 UTC www.besthealth.com [Source type: Academic]
  • GAMC Glendale, CA - Sarcoidosis. Sarcoidosis is a disease of unknown cause in ... 17 January 2010 12:25 UTC www.glendaleadventist.com [Source type: FILTERED WITH BAYES]
  • Sarcoidosis - Health Diseases & Medical Conditions - South Florida Hospital 17 January 2010 12:25 UTC www.mhs.net [Source type: FILTERED WITH BAYES]
  • Sarcoidosis - Health Information 17 January 2010 12:25 UTC www.qualityhealth.com [Source type: FILTERED WITH BAYES]
  • Sarcoidosis - Symptoms, Diagnosis, Treatment of Sarcoidosis - NY Times Health Information 17 January 2010 12:25 UTC health.nytimes.com [Source type: News]
  • Sarcoidosis - Lifespan 17 January 2010 12:25 UTC www.lifespan.org [Source type: Academic]
  • Sarcoidosis 17 January 2010 12:25 UTC www.drexelmed.edu [Source type: Academic]
  • Sarcoidosis - Baylor Health 17 January 2010 12:25 UTC info.baylorhealth.com [Source type: FILTERED WITH BAYES]
  • Wilmington/Newark - Sarcoidosis is a disease in which swelling (inflammation)... 17 January 2010 12:25 UTC www.christianacare.org [Source type: Academic]
  • Health Library 17 January 2010 12:25 UTC www.floridahospital.com [Source type: Academic]

^ No direct cause of sarcoidosis has been identified, although there have been reports of cell wall deficient bacteria that may be possible pathogens[1].

^ Neurosarcoidosis affecting the seventh cranial nerve causes Bell's palsy in 25% to 50% of cases.

.Granulomatous disease may cause atelectasis.^ Sarcoidosis: Disease that causes granulomatous inflammation.

^ Other countries report a lower occurrence, which may be due to a lack of screening programs or the presence of other granulomatous diseases such as tuberculosis.

^ Although the cause of sarcoidosis is unknown, the disease may be caused by an abnormal immune response to certain antigens .
  • sarcoidosis (pathology) -- Britannica Online Encyclopedia 17 January 2010 12:25 UTC www.britannica.com [Source type: Academic]

Diagnosis

.Diagnosis of sarcoidosis is often a matter of exclusion.^ Sarcoidosis is a diagnosis of exclusion.

^ In the absence of specific tests for sarcoidosis, it is essentially a diagnosis of exclusion.
  • Sarcoidosis in Chronic Granulomatous Disease -- De Ravin et al. 117 (3): e590 -- Pediatrics 17 January 2010 12:25 UTC pediatrics.aappublications.org [Source type: Academic]

^ The diagnosis of sarcoidosis relies on clinico-radiographical presentation and evidence of non caseating granulomas on biopsy specimens after appropriate exclusion of other granulomatous disorders [ 3 , 24 ].
  • Orphanet Journal of Rare Diseases | Full text | Sarcoidosis 17 January 2010 12:25 UTC www.ojrd.com [Source type: Academic]

.To exclude sarcoidosis in a case presenting with pulmonary symptoms might involve chest X-ray, CT scan of chest, PET scan, CT-guided biopsy, mediastinoscopy, open lung biopsy, bronchoscopy with biopsy, endobronchial ultrasound and endoscopic ultrasound with FNA of mediastinal lymph nodes.^ Sarcoidosis of the lungs is usually diagnosed using chest x-rays, pulmonary function tests, blood tests, and bronchoscopy with lung biopsy.
  • Sarcoidoisis, A Medical Mystery 17 January 2010 12:25 UTC noairtogo.tripod.com [Source type: FILTERED WITH BAYES]

^ Mine is of the lymph nodes and lungs.
  • Therapy for Sarcoidosis of Lungs and Thoracic Lymphatic Nodes 17 January 2010 12:25 UTC infoventures.com [Source type: General]

^ Historically, biopsies of scalene lymph nodes or mediastinoscopy were often performed.
  • Sarcoidosis: clinical update -- Costabel 18 (32 Supplement): 56S -- European Respiratory Journal 17 January 2010 12:25 UTC erj.ersjournals.com [Source type: Academic]

.Tissue from biopsy of lymph nodes is subjected to both flow cytometry to rule out cancer and special stains (acid fast bacilli stain and Gömöri methenamine silver stain) to rule out microorganisms and fungi.^ Lymphoma - Cancer of the lymph nodes.
  • What is Sarcoidosis? 17 January 2010 12:25 UTC www.medhelp.org [Source type: Academic]

^ Special stains were negative for infectious microorganisms.
  • ISPUB - Sarcoidosis Presenting as Interstitial Pneumonitis 17 January 2010 12:25 UTC www.ispub.com [Source type: Academic]

^ Special stains for acid-fast bacilli and fungi, as well as cultures of such organisms, are essential.
  • NEJM -- Sarcoidosis 17 January 2010 12:25 UTC content.nejm.org [Source type: Academic]

.Angiotensin-converting enzyme blood levels are used in diagnosis and monitoring of sarcoidosis.^ Polymorphism of angiotensin-converting enzyme gene in sarcoidosis.
  • Sarcoidosis: clinical update -- Costabel 18 (32 Supplement): 56S -- European Respiratory Journal 17 January 2010 12:25 UTC erj.ersjournals.com [Source type: Academic]

^ Angiotensin-converting enzyme levels may be elevated.
  • QRS: Urinary Incontinence; Sarcoidosis - JAAPA 17 January 2010 12:25 UTC www.jaapa.com [Source type: Academic]

^ Angiotensin-converting enzyme gene polymorphism and risk of sarcoidosis.
  • Sarcoidosis: clinical update -- Costabel 18 (32 Supplement): 56S -- European Respiratory Journal 17 January 2010 12:25 UTC erj.ersjournals.com [Source type: Academic]
  • Imaging Manifestations of Abdominal Sarcoidosis -- Warshauer and Lee 182 (1): 15 -- American Journal of Roentgenology 17 January 2010 12:25 UTC www.ajronline.org [Source type: Academic]

[14]

Investigations

.Because of wide range of possible manifestations the investigations to confirm diagnosis may involve many organs and methods depending on initial presentation.^ Other organs may also be involved.
  • Sarcoidosis: clinical update -- Costabel 18 (32 Supplement): 56S -- European Respiratory Journal 17 January 2010 12:25 UTC erj.ersjournals.com [Source type: Academic]

^ The organs may be symptomatic or silent in their presentation.
  • Bilateral parotid swelling caused by sarcoidosis -- SURATTANONT et al. 133 (6): 738 -- The Journal of the American Dental Association 17 January 2010 12:25 UTC jada.ada.org [Source type: Academic]

^ This is because it can affect so many different organs.
  • British Lung Foundation | Conditions and diseases | Sarcoidosis 17 January 2010 12:25 UTC www.lunguk.org [Source type: FILTERED WITH BAYES]

.Very often Sarcoidosis presents as a restrictive disease of the lungs, causing a decrease in lung volume and decreased compliance (the ability to stretch) - hence chest X-ray and other methods are used to assess the severity or rule out pulmonary disease.^ Thorough Medical Examination This is done to "rule out" other diseases that may present as sarcoidosis.
  • Sarcoidosis 17 January 2010 12:25 UTC www.pcca.net [Source type: FILTERED WITH BAYES]

^ Sarcoidosis: social predictors of severity at presentation.
  • NEJM -- Sarcoidosis 17 January 2010 12:25 UTC content.nejm.org [Source type: Academic]

^ Chest X Ray Chest x rays are frequently used to test for sarcoidosis and present a safe and easy method.
  • What is Sarcoidosis 17 January 2010 12:25 UTC www.squidoo.com [Source type: FILTERED WITH BAYES]

.The disease typically limits the amount of air drawn into the lungs, but produces higher than normal expiratory flow ratios.^ The disease typically limits the amount of air drawn into the lungs, but produces higher than normal expiratory flow ratios.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]
  • Sarcoidosis Support Group - DailyStrength 17 January 2010 12:25 UTC www.dailystrength.org [Source type: General]
  • Sarcoidosis Clinical Trials 17 January 2010 12:25 UTC www.clinicalconnection.com [Source type: Academic]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ As the disease progresses, granulomas and scarring (fibrosis) may occur in the tissue between the air sacs, stiffening your lungs and reducing the amount of air your lungs can hold.
  • dreddyclinic.com - Sarcoidosis 17 January 2010 12:25 UTC www.dreddyclinic.com [Source type: Academic]

^ Pulmonary sarcoidosis can cause loss of lung volume (the amount of air the lungs can hold) and abnormal lung stiffness.
  • Main Line Health - Pulmonary Sarcoidosis 17 January 2010 12:25 UTC www.mainlinehealth.org [Source type: Academic]

.The vital capacity (full breath in, to full breath out) is decreased, and most of this air can be blown out in the first second.^ The vital capacity (full breath in, to full breath out) is decreased, and most of this air can be blown out in the first second.
  • Sarcoidosis Support Group - DailyStrength 17 January 2010 12:25 UTC www.dailystrength.org [Source type: General]
  • Sarcoidosis Clinical Trials 17 January 2010 12:25 UTC www.clinicalconnection.com [Source type: Academic]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ These tests can show obstruction of air flow out of the lungs, restriction of the lung's ability to take in air and a decrease in the transport of oxygen from the lung into the blood stream.
  • Sarcoidosis - Symptoms, Treatment and Prevention 17 January 2010 12:25 UTC www.healthscout.com [Source type: Academic]

^ These tests can show obstruction of airflow out of the lungs, restriction of the lung's ability to take in air, and a decrease in the transport of oxygen from the lung into the blood stream.
  • Sarcoidosis 17 January 2010 12:25 UTC www.pcca.net [Source type: FILTERED WITH BAYES]

.This means the FEV1/FVC ratio is increased from the normal of about 80%, to 90%.^ This means the FEV 1 /FVC ratio is increased from the normal of about 80%, to 90%.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ This means the FEV1/FVC ratio is increased from the normal of about 80%, to 90%.

^ Pulmonary function testing showed a forced expiratory volume in one second (FEV 1 ) of 80 percent predicted but was otherwise entirely normal.
  • Sarcoidosis: A Primary Care Review - December 1998 - American Academy ofFamily Physicians 17 January 2010 12:25 UTC www.aafp.org [Source type: Academic]

.Obstructive lung changes, causing a decrease in the amount of air that can be exhaled, may occur when enlarged lymph nodes in the chest compress airways or when internal inflammation or nodules impede airflow.^ Other causes of enlarged lymph nodes are extremely rare.

^ Mine is of the lymph nodes and lungs.
  • Therapy for Sarcoidosis of Lungs and Thoracic Lymphatic Nodes 17 January 2010 12:25 UTC infoventures.com [Source type: General]

^ It may show granulomas or enlarged lymph nodes in the chest.
  • Sarcoidosis - Medpedia 17 January 2010 12:25 UTC wiki.medpedia.com [Source type: FILTERED WITH BAYES]

CT scan of the chest showing lymphadenopathy in the mediastinum due to sarcoidosis.
Chest X-ray changes are divided into four stages
  • Stage 1 bihilar lymphadenopathy
  • Stage 2 bihilar lymphadenopathy and reticulonodular infiltrates
  • Stage 3 bilateral pulmonary infiltrates
  • Stage 4 fibrocystic sarcoidosis typically with upward hilar retraction, cystic & bullous changes
.Investigations to asses involvement of other organs frequently involve electrocardiogram, ocular examination by an ophthalmologist, liver function tests, renal function tests, serum calcium and 24-hour urine calcium.^ Other organs may also be involved.
  • Sarcoidosis: clinical update -- Costabel 18 (32 Supplement): 56S -- European Respiratory Journal 17 January 2010 12:25 UTC erj.ersjournals.com [Source type: Academic]

^ Urine Test (24 hour urine calcium) .
  • Sarcoidosis - An overview 17 January 2010 12:25 UTC www.sarcoidosis.com.au [Source type: FILTERED WITH BAYES]

^ Urine Test 24-hour urine test to check for elevated levels of calcium in the urine.
  • Sarcoidosis ; Seattle Washington WA 17 January 2010 12:25 UTC www.swedish.org [Source type: FILTERED WITH BAYES]

In female patients sarcoidosis is significantly associated with hypothyroidism, hyperthyroidism and other thyroid diseases, hence close surveillance of thyroid function is recommended [15]

Causes and pathophysiology

.The exact cause of sarcoidosis is not known.^ The exact cause is not known.
  • Sarcoidosis | Health | Patient UK 17 January 2010 12:25 UTC www.patient.co.uk [Source type: General]

^ The cause of sarcoidosis is not known.
  • Sarcoidosis 17 January 2010 12:25 UTC patients.uptodate.com [Source type: Academic]
  • Sarcoidosis 17 January 2010 12:25 UTC www.nycpba.org [Source type: FILTERED WITH BAYES]
  • LUNG DISORDERS - Sarcoidosis 17 January 2010 12:25 UTC www.medic8.com [Source type: General]
  • Case 33--Radiology 17 January 2010 12:25 UTC pathhsw5m54.ucsf.edu [Source type: Academic]
  • Sarcoidosis - Definition, Description, Causes and symptoms, Diagnosis, Treatment, Prognosis, Prevention 17 January 2010 12:25 UTC health.stateuniversity.com [Source type: Academic]
  • Health topics - Sarcoidosis (General Information) 17 January 2010 12:25 UTC www.allina.com [Source type: General]

^ The exact cause of sarcoidosis is not known.
  • What is Sarcoidosis 17 January 2010 12:25 UTC my.clevelandclinic.org [Source type: Academic]
  • CIGNA - Sarcoidosis 17 January 2010 12:25 UTC www.cigna.com [Source type: Academic]
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]
  • Sarcoidosis | Health | Patient UK 17 January 2010 12:25 UTC www.patient.co.uk [Source type: General]

.The current working hypothesis is that in genetically susceptible individuals sarcoidosis is caused through alteration in immune response after exposure to an environmental, occupational, or infectious agent.^ The exact cause of sarcoidosis is not known, the current working hypothesis is that in genetically susceptible individuals sarcoidosis is caused through alteration in immune response after exposure to an environmental, occupational, or infectious agent.
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ This occurs through a complex immune response.
  • ISPUB - Pulmonary Sarcoidosis and Traditional Chinese Medicine 17 January 2010 12:25 UTC www.ispub.com [Source type: Academic]

^ Sarcoidosis is currently (1993) thought to be associated with an abnormal immune response.
  • Sarcoidosis and Celiac Disease 17 January 2010 12:25 UTC www.celiac.com [Source type: Academic]

[16]

Dysregulation of the immune system

.Granulomatous inflammation is characterized primarily by accumulation of monocytes, macrophages and activated T-lymphocytes, with increased production of key inflammatory mediators, TNF-alpha, INF-gamma, IL-2 and IL-12, characteristic of a Th1-polarized response (T-helper lymphocyte-1 response).^ Inhibition of IL-12 production by thalidomide.
  • Pulmonary sarcoidosis: management. Sharma OP - J Postgrad Med 17 January 2010 12:25 UTC www.jpgmonline.com [Source type: Academic]

^ Pentoxifylline inhibits TNF-alpha production from human alveolar macrophages.
  • Neurologic sarcoidosis 17 January 2010 12:25 UTC www.uptodate.com [Source type: Academic]

^ Numerous cytokines and other mediators are produced by both activated macrophages and T lymphocytes during granulomatous responses.
  • Orphanet Journal of Rare Diseases | Full text | Sarcoidosis 17 January 2010 12:25 UTC www.ojrd.com [Source type: Academic]

.Sarcoidosis has paradoxical effects on inflammatory processes; it is characterized by increased macrophage and CD4 helper T-cell activation resulting in accelerated inflammation, however, immune response to antigen challenges such as tuberculin is suppressed.^ Doctors believe sarcoidosis results from an abnormal immune response.
  • Sarcoidosis 17 January 2010 12:25 UTC www.cnn.com [Source type: General]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: General]
  • Sarcoidosis 17 January 2010 12:25 UTC e.a.cnn.net [Source type: General]
  • MayoClinic.com Health Library - Sarcoidosis 17 January 2010 12:25 UTC www.riversideonline.com [Source type: General]

^ Inflammation in sarcoidosis is dependent on persistent stimulation by CD4+ T cells.

^ Antigenic exposure leads to T-cell activation and an increase in CD4 + helper T cells.
  • Arthritis Research & Therapy | Full text | Pulmonary hypertension associated with sarcoidosis 17 January 2010 12:25 UTC arthritis-research.com [Source type: Academic]

.This paradoxic state of simultaneous hyper- and hypo- activity is suggestive of a state of anergy.^ This paradoxic state of hyper- and hypo- activity at the same time is suggestive of a state of anergy .
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

.The anergy may also be responsible for the increased risk of infections and cancer.^ An increased risk of infection.
  • Sarcoidosis | Health | Patient UK 17 January 2010 12:25 UTC www.patient.co.uk [Source type: General]

^ The anergy may also be responsible for the increased risk of infections and cancer.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ The liver and spleen may become enlarged Anaemia (low red blood cell/oxygen levels in the blood) may result from a very enlarged spleen Blood clotting of a higher or lower level than normal An increased risk of infections - but this is rare.
  • British Lung Foundation | Conditions and diseases | Sarcoidosis 17 January 2010 12:25 UTC www.lunguk.org [Source type: FILTERED WITH BAYES]

.It appears that regulatory T-lymphocytes in the periphery of sarcoid granulomas suppress IL-2 secretion which is hypothesized to cause the state of anergy by preventing antigen-specific memory responses.^ It appears that regulatory T-lymphocytes in the periphery of sarcoid granulomas suppress IL-2 secretion which is hypothesized to cause the state of anergy by preventing antigen-specific memory responses [6] .
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ It appears that regulatory T-lymphocytes in the periphery of sarcoid granulomas suppress IL-2 secretion which is hypothesized to cause the state of anergy by preventing antigen-specific memory responses.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ Although the cause of sarcoidosis is unknown, the disease may be caused by an abnormal immune response to certain antigens .
  • sarcoidosis (pathology) -- Britannica Online Encyclopedia 17 January 2010 12:25 UTC www.britannica.com [Source type: Academic]

[17]
.While it is widely believed that TNF-alpha plays an important role in the formation of granulomas, it was observed that sarcoidosis can be triggered by treatment with the TNF-alpha antagonist etanercept.^ Another important dimension to consider in pulmonary sarcoidosis is the formation of granulomas.
  • ISPUB - Pulmonary Sarcoidosis and Traditional Chinese Medicine 17 January 2010 12:25 UTC www.ispub.com [Source type: Academic]

^ While it is widely believed that TNF-alpha plays an important role in the formation of granulomas it was observed that sarcoidosis can be triggered by treatment with the TNF-alpha antagonist etanercept .
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ This leads to granuloma formation, the hallmark of sarcoidosis.

[18][19]

Genetic associations

.Investigations of genetic susceptibility yielded many candidate genes but only few were confirmed by further investigations and no reliable genetic markers are known.^ Investigations of genetic susceptibility yielded many candidate genes but only few were confirmed by further investigations and no reliable genetic markers are known.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ It appears likely that a genetic susceptibility is combined with a triggering infection, but despite several candidate genes and microorganisms being suggested, there is no definitive evidence in favour of particular ones, as yet.
  • Sarcoidosis | Doctor | Patient UK 17 January 2010 12:25 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

^ To date, no reliable genetic markers have been identified, and an alternate hypothesis is that family members share similar exposures to environmental pathogens.

.Currently most interesting candidate gene is BTNL2, several HLA-DR risk alleles are also investigated.^ Currently most interesting candidate gene is BTNL2 , several HLA-DR risk alleles are also investigated.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ Investigations of genetic susceptibility yielded many candidate genes but only few were confirmed by further investigations and no reliable genetic markers are known.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ HLA genes have been the most extensively studied susceptibility genes in sarcoidosis.

[20] .In persistent sarcoidosis the HLA haplotype HLA-B7-DR15 are either cooperating in disease or another gene between these two loci is associated.^ In persistent sarcoidosis the HLA haplotype HLA-B7 - DR15 are either cooperating in disease or another gene between these two loci is associated.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ Restricted V alpha 2.3 gene usage by CD4+ T lymphocytes in bronchoalveolar lavage fluid from sarcoidosis patients correlates with HLA-DR3.
  • Corticosteroid treatment in sarcoidosis -- Grutters and van den Bosch 28 (3): 627 -- European Respiratory Journal 17 January 2010 12:25 UTC erj.ersjournals.com [Source type: Academic]

^ In non-persistent disease there is a strong genetic association with HLA DR3-DQ2 .
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

.In non-persistent disease there is a strong genetic association with HLA DR3-DQ2.^ In non-persistent disease there is a strong genetic association with HLA DR3-DQ2 .
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ In persistent sarcoidosis the HLA haplotype HLA-B7 - DR15 are either cooperating in disease or another gene between these two loci is associated.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ The HLA-B22 phenotype is associated with disseminated systemic disease in Italians 9 .
  • Sarcoidosis: clinical update -- Costabel 18 (32 Supplement): 56S -- European Respiratory Journal 17 January 2010 12:25 UTC erj.ersjournals.com [Source type: Academic]

[21] .Siblings have only a modestly increased risk (hazard ratio 5-6) to develop the disease, indicating that genetic susceptibility plays only a small role.^ An increased risk of developing diabetes.
  • Sarcoidosis | Health | Patient UK 17 January 2010 12:25 UTC www.patient.co.uk [Source type: General]

^ Siblings have a fivefold increased risk of developing sarcoidosis.

^ Siblings of those affected with sarcoidosis have a modestly increased disease risk, with an odds ratio of about 5.

.The alternate hypothesis that family members share similar exposures to environmental pathogens is quite plausible to explain the apparent hereditary factor.^ The alternate hypothesis that family members share similar exposures to environmental pathogens is quite plausible to explain the apparent hereditary factor.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ Obviously, the alternative explanation is that family members share environmental bacterial exposure.
  • http://www.marshallprotocol.com/forum37/3094.html 17 January 2010 12:25 UTC www.marshallprotocol.com [Source type: FILTERED WITH BAYES]

^ To date, no reliable genetic markers have been identified, and an alternate hypothesis is that family members share similar exposures to environmental pathogens.

Infectious agents

.Several infectious agents appear to be significantly associated with sarcoidosis but none of the known associations is specific enough to suggest a direct causative role.^ Several infectious organisms have been implicated as possible agents in the aetiology of sarcoidosis, e.g.
  • Sarcoidosis: clinical update -- Costabel 18 (32 Supplement): 56S -- European Respiratory Journal 17 January 2010 12:25 UTC erj.ersjournals.com [Source type: Academic]

^ Several infectious agents appear to be significantly associated with sarcoidosis but none of the known associations is specific enough to suggest a direct causative role.
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ Because the cause of sarcoidosis is not known, there is no specific treatment.

.Propionibacterium acnes can be found in bronchoalveolar lavage of approximately 70% patients and is associated with disease activity, however it can be also found in 23% of controls.^ "Propionibacterium acnes DNA detected in bronchoalveolar lavage cells from patients with sarcoidosis".
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ Propionibacterium acnes can be found in bronchoalveolar lavage of approximately 70% patients and is associated with disease activity, however it can be also found in 23% of controls.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ Stroke, Heart Attack Found Higher in Migraine Patients PHILADELPHIA — Migraine with or without aura is associated with a significant increase in the risk of cardiovascular...

[22][23] .A recent meta-analysis investigating the role of mycobacteria in sarcoidosis found it was present in 26.4% of cases, however the meta-analysis also detected a possible publication bias, so the results need further confirmation.^ A recent meta-analysis investigating the role of mycobacteria in sarcoidosis found it was present in 26.4% of cases, however the meta-analysis also detected a possible publication bias, so the results need further confirmation.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ A recent meta-analysis investigating the role of mycobacteria in sarcoidosis found it was present in 26.4% of cases, however the meta-analysis also detected a possible publication bias, so the results need further confirmation [10] [11] .
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ "Molecular evidence for the role of mycobacteria in sarcoidosis: a meta-analysis".
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

[24][25]
.There have also been reports of transmission of sarcoidosis via organ transplants.^ There have also been reports of transmission of sarcoidosis via organ transplants.

^ Here are some of the reported cases: Transmission of sarcoidosis via cardiac transplantation.
  • http://www.marshallprotocol.com/forum37/3094.html 17 January 2010 12:25 UTC www.marshallprotocol.com [Source type: FILTERED WITH BAYES]

^ Possible transmission of sarcoidosis via allogeneic bone marrow transplantation.
  • http://www.marshallprotocol.com/forum37/3094.html 17 January 2010 12:25 UTC www.marshallprotocol.com [Source type: FILTERED WITH BAYES]
  • Sarcoidosis: clinical update -- Costabel 18 (32 Supplement): 56S -- European Respiratory Journal 17 January 2010 12:25 UTC erj.ersjournals.com [Source type: Academic]
  • Case 33--Radiology 17 January 2010 12:25 UTC pathhsw5m54.ucsf.edu [Source type: Academic]

[26]

Vitamin D dysregulation

.Sarcoidosis frequently causes a dysregulation of vitamin D production with an increase in extrarenal (outside the kidney) production.^ Sarcoidosis frequently causes a dysregulation of vitamin D production with an increase in extrarenal (outside the kidney) production.
  • Sarcoidosis Clinical Trials 17 January 2010 12:25 UTC www.clinicalconnection.com [Source type: Academic]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]
  • Sarcoidosis - Causes, Symptoms and Treatment 17 January 2010 12:25 UTC www.cosmeticsdiary.com [Source type: Academic]

^ Special care must be taken if vitamin D or calcium is supplemented in patients with sarcoidosis because this disease may cause hypercalcinuria or hypercalcaemia by increased endogenous production of vitamin D, with subsequent increases in calcium absorption in the intestine, resorption in the bones and excretion in the kidney 1 , 96 .
  • Corticosteroid treatment in sarcoidosis -- Grutters and van den Bosch 28 (3): 627 -- European Respiratory Journal 17 January 2010 12:25 UTC erj.ersjournals.com [Source type: Academic]

^ Sarcoidosis frequently causes mild symptoms and resolves on its own.

[27] .Specifically, macrophages inside the granulomas convert vitamin D to its active form, resulting in elevated levels of the hormone 1,25-dihydroxyvitamin D and symptoms of hypervitaminosis D that may include fatigue, lack of strength or energy, irritability, metallic taste, temporary memory loss or cognitive problems.^ Hypercalcemia (high calcium levels) and its symptoms may be the result of excessive vitamin D production.
  • Sarcoidosis Support Group - DailyStrength 17 January 2010 12:25 UTC www.dailystrength.org [Source type: General]

^ Specifically, macrophages inside the granulomas convert vitamin D to its active form, resulting in elevated levels of the hormone 1,25-dihydroxyvitamin D and symptoms of hypervitaminosis D that may include fatigue , lack of strength or energy, irritability , metallic taste , temporary memory loss or cognitive problems.
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ This is then converted to 1,25 dihydroxyvitamin D3 , the active Vit D hormone in our bodies.
  • http://www.marshallprotocol.com/forum37/3094.html 17 January 2010 12:25 UTC www.marshallprotocol.com [Source type: FILTERED WITH BAYES]

.Physiological compensatory responses (e.g., suppression of the parathyroid hormone levels) may mean the patient does not develop frank hypercalcemia.^ D suppresses circulating levels of parathyroid hormone in a patient with primary hyperparathyroidism and coexistent sarcoidosis.

^ Granuloma may then be responsible for its own perpetuation and for progression to fibrosis although some modulation must occur since fibrosis does not always accompany the granulomas of sarcoidosis.

^ Because prolonged sun exposure in patients with sarcoidosis may result in acute hypercalcemia, an episode of pancreatitis may be the initial presentation of sarcoidosis in patients on vacation in sunny climates [ 37 ].
  • Imaging Manifestations of Abdominal Sarcoidosis -- Warshauer and Lee 182 (1): 15 -- American Journal of Roentgenology 17 January 2010 12:25 UTC www.ajronline.org [Source type: Academic]

.This condition may be aggravated by high levels of estradiol and prolactin such as in pregnancy, leading to hypercalciuria and/or compensatory hypoparathyroidism.^ This condition may be aggravated by high levels of estradiol and prolactin such as in pregnancy, leading to hypercalciuria and/or compensatory hypoparathyroidism .
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ This condition may be aggravated by high levels of estradiol and prolactin such as in pregnancy, leading to hypercalciuria and/or compensatory hypoparathyroidism [14] .
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ High calcium levels can then lead to kidney stones as urine is passed through the kidneys.
  • What is Sarcoidosis 17 January 2010 12:25 UTC www.squidoo.com [Source type: FILTERED WITH BAYES]

[28] .High levels of Vitamin D are also implicated in immune-system dysfunctions which tie into the sarcoid condition.^ Vitamin D and the immune system.

^ Sometimes the immune system is successful, and the patient goes into "remission".

^ The concentration of this hormone in the blood of sarcoid patients can rise to quite high levels, and cause them to suffer from the symptoms of "Hypervitaminosis D".

The connection between Vitamin D dysregulation, its effects on immune function, and how the combined effect might mediate sarcoidosis, is currently being explored by Dr. Trevor Marshall. The theory which Dr. Marshall is currently researching via a protocol (the Marshall Protocol) under FDA oversight, asserts that L-form or cell wall deficient bacteria infect the body, and evade the immune system by inducing or enhancing this Vitamin D disregulation, which in turn suppresses the body's immune response to said bacterial infection. Dr. Marshall's research is highly controversial, and the Marshall Protocol's suggestion that people should avoid all sources of vitamin D contradicts a vast body of medical knowledge concerning the benefits of vitamin D. No research about the efficacy of the Marshall Protocol has been published in a medical journal. Marshall is not a medical doctor; his doctorate is in electrical engineering.[29]

Hyperprolactinemia

.Prolactin is frequently increased in sarcoidosis, between 3–32% cases have hyperprolactinemia,[30] this frequently leads to amenorrhea, galactorrhea or nonpuerperal mastitis in women.^ Prolactin is frequently increased in sarcoidosis, between 3–32% cases develop hyperprolactinemia .
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ Sarcoidosis most often occurs between 20 and 40 years of age, and is diagnosed more often in women than in men.

^ The frequency of specific skin manifestations of sarcoidosis ranges from 10 to 40% cases [ 28 ].
  • Orphanet Journal of Rare Diseases | Full text | Sarcoidosis 17 January 2010 12:25 UTC www.ojrd.com [Source type: Academic]

.Prolactin also has a broad spectrum of effects on the immune system and increased prolactin levels are associated with disease activity or may exacerbate symptoms in many autoimmune diseases and treatment with prolactin lowering medication has been shown effective in some cases.^ Some medications are effective in suppressing symptoms, and these are discussed below.

^ Prolactin also has a broad spectrum of effects on the immune system and increased prolactin levels are associated with disease activity or may exacerbate symptoms in many autoimmune diseases and treatment with prolactin lowering medication has been shown effective in some cases.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ The following symptoms are common in many, if not all, autoimmune diseases.
  • Understanding and Healing Sarcoidosis. 17 January 2010 12:25 UTC www.health-reports.com [Source type: FILTERED WITH BAYES]

[31] .However it is unknown if this relation holds in sarcoidosis and the gender predilection in sarcoidosis is less pronounced than in some other autoimmune diseases where such relation has been established.^ Or is it some other disease, as some of the doctors have hypothesised?
  • Therapy for Sarcoidosis of Lungs and Thoracic Lymphatic Nodes 17 January 2010 12:25 UTC www.infoventures.com [Source type: Original source]

^ I can relate to Bernie and some of the other people with Sarcoidosis.

^ Sarcoidosis shares much in common with other autoimmune diseases.
  • Understanding and Healing Sarcoidosis. 17 January 2010 12:25 UTC www.health-reports.com [Source type: FILTERED WITH BAYES]

.In pregnancy, the effects of prolactin and estrogen counteract each other to some degree, with a slight trend to improve pulmonary manifestations of sarcoidosis while lupus, uveitis and arthralgia might slightly worsen.^ In pregnancy the effects of prolactin and estrogen counteract each other to some degree, with a slight trend to improve pulmonary manifestations of sarcoidosis while lupus, uveitis and arthralgia might slightly worsen.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ Gas exchange at a given degree of volume restriction is different in sarcoidosis and idiopathic pulmonary fibrosis.
  • Clinical manifestations and diagnosis of sarcoidosis 17 January 2010 12:25 UTC www.uptodate.com [Source type: Academic]

^ Sarcoidosis is a multisystem disease that commonly involves the pulmonary, cutaneous, and ocular systems, but can also affect many other systems, including the liver, heart, and nervous system ( 1 ).
  • Examining the Link between Sarcoidosis and Depression -- Randall Curtis and Borson 163 (2): 306 -- American Journal of Respiratory and Critical Care Medicine 17 January 2010 12:25 UTC ajrccm.atsjournals.org [Source type: Academic]

[28] .Lupus, uveitis and arthralgia are known to be in some cases associated with increased prolactin levels and respond to bromocriptin treatment but so far this has not been investigated specifically for sarcoidosis.^ Sixteen cases of uveitis associated with sarcoidosis.

^ The reasons for increased prolactin levels in sarcoidosis are hitherto uncertain.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ Because the cause of sarcoidosis is not known, there is no specific treatment.

.The reasons for increased prolactin levels in sarcoidosis are uncertain.^ The reasons for increased prolactin levels in sarcoidosis are hitherto uncertain.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ Prolactin is frequently increased in sarcoidosis, between 3–32% cases have hyperprolactinemia , this frequently leads to amenorrhea , galactorrhea or nonpuerperal mastitis in women.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ This is usually seen as secondary complication of sarcoidosis, however recent evidence suggests that increased prolactin levels can exacerbate symptoms of many autoimmune diseases [15] [16] .
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

.It has been observed that prolactin is produced by T-lymphocytes in some autoimmune disorders in amounts high enough to affect the feedback by the hypothalamic dopaminergic system.^ Using this technique it has been determined that cells from sarcoid patients contain high proportions and absolute amounts/ml of fluid of lymphocytes.

^ Remission is observed as a gradual decrease in the amount of extra-renal 1,25-dihydroxyvitamin D being produced within the granulomatous biochemistry.
  • Remission in Sarcoidosis -- clinmed/2002080004v1 -- Clinical Medicine NetPrints 17 January 2010 12:25 UTC clinmed.netprints.org [Source type: Academic]

[32]
.The extrapituitary prolactin is believed to play a role as a cytokine like proinflammatory factor.^ The extrapituitary prolactin is believed to play a role as a cytokine like proinflammatory factor.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ Recent advances on the knowledge of sarcoidosis pathogeny suggest that the overproduction of tumor necrosis factor α (TNF- α ) at the sites of disease plays a pivotal role [ 2 ].
  • Orphanet Journal of Rare Diseases | Full text | Sarcoidosis 17 January 2010 12:25 UTC www.ojrd.com [Source type: Academic]

^ Genetic as well as environmental factors are thought to play a role in the disease process.

.Prolactin antibodies are believed to play a role in hyperprolactinemia in other autoimmune disorders and high prevalence endocrine autoimmunity has been observed in patients with sarcoidosis.^ Prolactin antibodies are believed to play a role in hyperprolactinemia in other autoimmune disorders and high prevalence endocrine autoimmunity has been observed in patients with sarcoidosis .
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ Sarcoidosis and other granulomatous disorders.

^ Association of autoimmune disorders has been frequently observed.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

[33] .It may also be a consequence of renal disease or treatment with steroids.^ It may also be a consequence of renal disease or treatment with steroids.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ Support Groups: Expectations (prognosis): Many people are not seriously ill, and the disease may resolve without treatment.
  • Health Los Angeles - Sarcoidosis. Sarcoidosis is a disease of unknown cause in... 17 January 2010 12:25 UTC www.uclahealth.org [Source type: Academic]

^ Treatment, therefore, may be necessary for several years, sometimes for as long as the disease remains active or to prevent relapse.

.Neurosarcoidosis may occasionally cause hypopituiarism but has not been reported to cause hyperprolactinemia.^ Neurosarcoidosis may occasionally cause hypopituiarism but has not been reported to cause hyperprolactinemia.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ Highly variable reports on effectiveness; may be useful for treatment of neurosarcoidosis .
  • Sarcoidosis - July 15, 2004 - American Family Physician 17 January 2010 12:25 UTC www.aafp.org [Source type: Academic]

^ No direct cause of sarcoidosis has been identified, although there have been reports of cell wall deficient bacteria that may be possible pathogens.

Thyroid disease

.In women, a substantial association of thyroid disease and sarcoidosis has been reported.^ Sarcoidosis has been associated with celiac disease.

^ Sarcoidosis has been associated with celiac disease .
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ Are other rheumatological diseases associated with sarcoidosis?

.The association is less marked but still significant for male patients.^ The association is less marked but still significant for male patients.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ Stroke, Heart Attack Found Higher in Migraine Patients PHILADELPHIA — Migraine with or without aura is associated with a significant increase in the risk of cardiovascular...

^ Patients with OP associated with collagen vascular diseases respond less well to therapy with steroids.

.Female patients have a significantly elevated risk for hypothyroidism, hyperthyroidism and thyroid autoimmunity and it appears that autoimmunity is very important in the pathogenesis of thyroid disease in this population.^ Female patients have a significantly elevated risk for hypothyroidism, hyperthyroidism and thyroid autoimmunity and it appears that autoimmunity is very important in the pathogenesis of thyroid disease in this population.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ In female patients sarcoidosis is significantly associated with hypothyroidism, hyperthyroidism and other thyroid diseases, hence close surveillance of thyroid function is recommended .
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ It is important to recognize that these two conditions can occur together and that unexplained weight loss in a patient with sarcoidosis may be caused by celiac disease.
  • Sarcoidosis and Celiac Disease 17 January 2010 12:25 UTC www.celiac.com [Source type: Academic]

.Thyroid granulomatosis on the other hand is uncommon.^ Thyroid granulomatosis on the other hand is uncommon .
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

[15]

Hypersensitivity/autoimmune

.Association of autoimmune disorders has been frequently observed.^ CONCLUSION: Papular sarcoidosis of the knees can be considered a frequent form of cutaneous sarcoidosis, mainly observed in acute forms of the disease, and frequently associated with erythema nodosum.

.The exact mechanism of this relation is not known but some evidence supports the hypothesis that this is a consequence of Th1 lymphokine prevalence.^ The exact mechanism of this relation is not known but some evidence supports the hypothesis that this is a consequence of Th1 lymphokine prevalence .
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ Skin-Tightening Device Evidence Is Rather Loose PHOENIX Some devices commonly touted for skin tightening are supported by evidence-based medicine, although few have data...

^ The exact prevalence (estimated at 10 to 20 per 100,000 population) and annual incidence of sarcoidosis are not known with certainty.
  • Clinical manifestations and diagnosis of sarcoidosis 17 January 2010 12:25 UTC www.uptodate.com [Source type: Academic]

[34][15]
.Sarcoidosis has been associated with celiac disease.^ Are other rheumatological diseases associated with sarcoidosis?

^ Sarcoidosis has been associated with celiac disease.

^ Sarcoidosis and Celiac Disease Celiac.com Sponsor: Celiac.com Sponsor: Celiac.com Sponsor: Celiac.com Sponsor: Celiac.com Sponsor: .
  • Sarcoidosis and Celiac Disease 17 January 2010 12:25 UTC www.celiac.com [Source type: Academic]

.Celiac disease is a condition in which there is a chronic reaction to certain protein chains, commonly referred to as glutens, found in some cereal grains.^ Celiac disease is a condition in which there is a chronic reaction to certain protein chains, commonly referred to as glutens, found in some cereal grains.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]
  • Sarcoidosis Clinical Trials 17 January 2010 12:25 UTC www.clinicalconnection.com [Source type: Academic]

^ The veteran is able to file for compensation with the VA if there disease/condition is on this list.
  • ksl.com - VA admits �Agent Orange' caused Utah man's heart disease 17 January 2010 12:25 UTC www.ksl.com [Source type: General]

^ They are found in other conditions, for example, Crohn's disease and malignant diseases such as lymphomas.
  • Sarcoidosis in Chronic Granulomatous Disease -- De Ravin et al. 117 (3): e590 -- Pediatrics 17 January 2010 12:25 UTC pediatrics.aappublications.org [Source type: Academic]

.This reaction causes destruction of the villi in the small intestine, with resulting malabsorption of nutrients.^ This reaction causes destruction of the villi in the small intestine, with resulting malabsorption of nutrients.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]
  • Sarcoidosis Clinical Trials 17 January 2010 12:25 UTC www.clinicalconnection.com [Source type: Academic]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ Rheumatoid Arthritis: A long-term, destructive connective tissue disease that results from the body rejecting its own tissue cells (autoimmune reaction).

^ One case of venous insufficiency in the small intestine resulting from sarcoid nodes compressing the mesenteric vein has also been described [ 31 ].
  • Imaging Manifestations of Abdominal Sarcoidosis -- Warshauer and Lee 182 (1): 15 -- American Journal of Roentgenology 17 January 2010 12:25 UTC www.ajronline.org [Source type: Academic]

.An association with type IV hypersensitivity has been described.^ An association with type IV hypersensitivity has been described.
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]

^ The response of the peripheral lymphocytes to antigen is impaired, and type IV hypersensitivity responses are depressed (2).
  • Baylor Health Care System: Sarcoidosis 17 January 2010 12:25 UTC www.baylorhealth.edu [Source type: Academic]

^ The Kveim reaction differs from the classic delayed type IV hypersensitivity skin reaction.
  • Baylor Health Care System: Sarcoidosis 17 January 2010 12:25 UTC www.baylorhealth.edu [Source type: Academic]

[35] .Tests of delayed cutaneous hypersensitivity have been used to measure progression.^ Cutaneous anergy to wide variety of agents normally induce a local cutaneous delayed hypersensitivity reaction (e.g.

^ Progress of recovery can be monitored using chest x rays and breathing tests.
  • What is Sarcoidosis 17 January 2010 12:25 UTC www.squidoo.com [Source type: FILTERED WITH BAYES]

^ Frequently observed immunological features are depression of cutaneous delayed-type hypersensitivity and increased CD4/CD8 ratio at the site of involvement.
  • Sarcoidosis: clinical update -- Costabel 18 (32 Supplement): 56S -- European Respiratory Journal 17 January 2010 12:25 UTC erj.ersjournals.com [Source type: Academic]

[36]

Other

.While disputed, some cases have been associated with inhalation of the dust from the collapse of the World Trade Center after the September 11, 2001 attacks.^ While disputed, some cases have been determined to be caused by inhalation of the dust from the collapse of the World Trade Center after the September 11, 2001 attacks .
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ While disputed, some cases have been determined to be caused by inhalation of the dust from the collapse of the World Trade Center after the September 11, 2001 attacks.

^ On May 7, 2007, in the first clinical study to connect World Trade Center dust to serious and on occasion fatal diseases, doctors discovered that the number of New York City rescue and recovery workers with a rare type of lung-scarring condition soared in the year after the trade center collapsed.
  • World Trade Center Emergency Workers Health Ailment Sarcoidosis Disease Lawyer 17 January 2010 12:25 UTC www.yourlawyer.com [Source type: News]

[37] See Health effects arising from the September 11, 2001 attacks for more information.

Pregnancy

.Sarcoidosis generally does not prevent successful pregnancy and delivery, the endogenous estrogen in pregnancy may even have a slightly beneficial immunomodulatory effect.^ Sarcoidosis does not influence pregnancy adversely.
  • Orphanet Journal of Rare Diseases | Full text | Sarcoidosis 17 January 2010 12:25 UTC www.ojrd.com [Source type: Academic]

^ Some patients with sarcoidosis may have allergies that cause asthma, but sarcoidosis does not develop into asthma.

^ Since sarcoidosis may induce hypercalciuria and hypercalcaemia by increased endogenous vitamin D production, patients should be monitored closely when vitamin D or calcium is supplemented for osteoporosis prevention 115 .
  • Sarcoidosis: clinical update -- Costabel 18 (32 Supplement): 56S -- European Respiratory Journal 17 January 2010 12:25 UTC erj.ersjournals.com [Source type: Academic]

.In most cases the course of sarcoidosis is unaffected by pregnancy, there is improvement in a few cases and worsening of symptoms in very few cases.^ The following are the most common symptoms for sarcoidosis.
  • Pulmonary Sarcoidosis, Robert Wood Johnson University Hospital, New Brunswick, NJ, 08903 17 January 2010 12:25 UTC www.rwjuh.edu [Source type: Academic]
  • Pulmonary Sarcoidosis 17 January 2010 12:25 UTC www.sharp.com [Source type: Academic]

^ In some cases, there are few, if any, noticeable symptoms.
  • CIGNA - Sarcoidosis 17 January 2010 12:25 UTC www.cigna.com [Source type: Academic]

^ In a few cases, sarcoidosis can be fatal.
  • Sarcoidosis 17 January 2010 12:25 UTC www.cnn.com [Source type: General]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: General]
  • Sarcoidosis 17 January 2010 12:25 UTC edition.cnn.com [Source type: General]
  • OhioHealth - Sarcoidosis 17 January 2010 12:25 UTC www.ohiohealth.com [Source type: General]
  • Sarcoidosis 17 January 2010 12:25 UTC e.a.cnn.net [Source type: General]
  • MayoClinic.com Health Library - Sarcoidosis 17 January 2010 12:25 UTC www.riversideonline.com [Source type: General]

[28]

Treatment

.Between 30 and 70% of patients do not require therapy.^ Between 30 and 70% of patients never require therapy.
  • Orphanet Journal of Rare Diseases | Full text | Sarcoidosis 17 January 2010 12:25 UTC www.ojrd.com [Source type: Academic]

^ Some patients experience repeated relapses and may require long-term low-dose corticosteroid therapy during years.
  • Orphanet Journal of Rare Diseases | Full text | Sarcoidosis 17 January 2010 12:25 UTC www.ojrd.com [Source type: Academic]

^ About 1/3 of patients required continued steroid therapy.

[3] .Corticosteroids, most commonly prednisone, have been the standard treatment for many years.^ Corticosteroids, most commonly prednisone, have been the standard treatment for many years.

^ The most commonly used drugs are corticosteroids (cortisone, prednisone, methylprednisolone).

^ Thus, many patients with recurrent relapses need treatment for prolonged periods, sometimes for years.
  • Pulmonary sarcoidosis: management. Sharma OP - J Postgrad Med 17 January 2010 12:25 UTC www.jpgmonline.com [Source type: Academic]

.In some patients, this treatment can slow or reverse the course of the disease, but other patients do not respond to steroid therapy.^ Or is it some other disease, as some of the doctors have hypothesised?
  • Therapy for Sarcoidosis of Lungs and Thoracic Lymphatic Nodes 17 January 2010 12:25 UTC www.infoventures.com [Source type: Original source]

^ In some patients, this treatment can slow or reverse the course of the disease, but other patients do not respond to steroid therapy.
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ Patients respond promptly to treatment with steroids.

.The use of corticosteroids in mild disease is controversial because in many cases the disease remits spontaneously.^ The use of corticosteroids in mild disease is controversial because in many cases the disease remits spontaneously.

^ The use of corticosteroids in mild disease is controversial because many times the disease can remit spontaneously.
  • Sarcoidosis Support Group - DailyStrength 17 January 2010 12:25 UTC www.dailystrength.org [Source type: General]

^ Additionally, corticosteroids have many recognized dose- and duration-related side effects (which can be reduced through the use of alternate-day dosing for those on chronic prednisone therapy), and their use is generally limited to severe, progressive, or organ-threatening disease.

[38] .Additionally, corticosteroids have many recognized dose- and duration-related side effects (which can be reduced through the use of alternate-day dosing for those on chronic prednisone therapy),[39] and their use is generally limited to severe, progressive, or organ-threatening disease.^ High toxicity limits its use to patients with severe refractory disease.
  • Sarcoidosis - July 15, 2004 - American Family Physician 17 January 2010 12:25 UTC www.aafp.org [Source type: Academic]

^ Unfortunately, prednisone has a number of side-effects.
  • ISPUB - Pulmonary Sarcoidosis and Traditional Chinese Medicine 17 January 2010 12:25 UTC www.ispub.com [Source type: Academic]

^ Hydroxychloroquine does not have many side effects.

.The influence of corticosteroids or other immunosuppressants on the natural history is unclear.^ The influence of corticosteroids or other immunosuppressants on the natural history is unclear.

^ In addition, there are still no data regarding theoptimal dose and duration of corticosteroid or other immunosuppressive therapy."
  • http://www.marshallprotocol.com/forum37/3094.html 17 January 2010 12:25 UTC www.marshallprotocol.com [Source type: FILTERED WITH BAYES]

^ It is not surprising then that long term studies of the effects of corticosteroid therapy on the natural history of the disease have been inconclusive.

.Severe symptoms are generally treated with steroids, and steroid-sparing agents such as azathioprine and methotrexate are often used.^ Methotrexate or azathioprine may be used for patients who do not respond to steroids.

^ Severe symptoms are generally treated with steroids, and steroid-sparing agents such as azathioprine and methotrexate are often used.
  • Sarcoidosis Clinical Trials 17 January 2010 12:25 UTC www.clinicalconnection.com [Source type: Academic]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ Heart Steroids can be used to treat sarcoidosis of the heart.
  • What is Sarcoidosis 17 January 2010 12:25 UTC www.squidoo.com [Source type: FILTERED WITH BAYES]

.Rarely, cyclophosphamide has also been used.^ Rarely, cyclophosphamide has also been used.

^ Cyclophosphamide: Cyclophosphamide is a highly toxic medication that is rarely used in the treatment of Sarcoidosis.
  • Sarcoidosis Disease Information 17 January 2010 12:25 UTC www.disabled-world.com [Source type: FILTERED WITH BAYES]

.As the granulomas are caused by collections of immune system cells, particularly T cells, there has been some early indications of success using immunosuppressants, interleukin-2 inhibitors or anti-tumor necrosis factor-alpha treatment (such as infliximab).^ As the granulomas are caused by collections of immune system cells, particularly T cells, there has been some early indications of success using immunosuppressants, interleukin-2 inhibitors or anti-tumor necrosis factor-alpha treatment (such as infliximab).

^ Yee AM, Pochapin MB. Treatment of complicated sarcoidosis with infliximab anti-tumor necrosis factor-alpha therapy.
  • Sarcoidosis: eMedicine Pulmonology 17 January 2010 12:25 UTC emedicine.medscape.com [Source type: Academic]
  • Sarcoidosis - July 15, 2004 - American Family Physician 17 January 2010 12:25 UTC www.aafp.org [Source type: Academic]

^ Successful tumor necrosis factor alpha blockade treatment in therapy-resistant sarcoidosis.
  • CIGNA - Sarcoidosis 17 January 2010 12:25 UTC www.cigna.com [Source type: Academic]

.Unfortunately, none of these has provided reliable treatment, and there can be significant side effects such as an increased risk of reactivating latent tuberculosis.^ Unfortunately, prednisone has a number of side-effects.
  • ISPUB - Pulmonary Sarcoidosis and Traditional Chinese Medicine 17 January 2010 12:25 UTC www.ispub.com [Source type: Academic]

^ These side effects include: .
  • Sarcoidosis 17 January 2010 12:25 UTC www.cnn.com [Source type: General]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: General]
  • Sarcoidosis 17 January 2010 12:25 UTC edition.cnn.com [Source type: General]
  • OhioHealth - Sarcoidosis 17 January 2010 12:25 UTC www.ohiohealth.com [Source type: General]
  • Sarcoidosis 17 January 2010 12:25 UTC e.a.cnn.net [Source type: General]
  • MayoClinic.com Health Library - Sarcoidosis 17 January 2010 12:25 UTC www.riversideonline.com [Source type: General]

^ Unfortunately, none of these have provided reliable treatment and there can be signficant side effects such as an increased risk of reactivating latent tuberculosis.
  • Sarcoidosis Support Group - DailyStrength 17 January 2010 12:25 UTC www.dailystrength.org [Source type: General]

.Anti-tumor necrosis factor-alpha treatment with etanercept in rheumatoid arthritis has been observed to cause sarcoidosis.^ Yee AM, Pochapin MB. Treatment of complicated sarcoidosis with infliximab anti-tumor necrosis-alpha therapy.
  • USPharmacist.com > Sarcoidosis 17 January 2010 12:25 UTC www.uspharmacist.com [Source type: Academic]

^ Yee AM, Pochapin MB. Treatment of complicated sarcoidosis with infliximab anti-tumor necrosis factor-alpha therapy.
  • Sarcoidosis: eMedicine Pulmonology 17 January 2010 12:25 UTC emedicine.medscape.com [Source type: Academic]
  • Sarcoidosis - July 15, 2004 - American Family Physician 17 January 2010 12:25 UTC www.aafp.org [Source type: Academic]

^ Many of them modulate the activity of tumor necrosis factor alpha (TNF-α).
  • Sarcoidosis - July 15, 2004 - American Family Physician 17 January 2010 12:25 UTC www.aafp.org [Source type: Academic]

[18]
.The connection between vitamin D dysregulation and the emergence of sarcoidosis is being explored under the Marshall Protocol, which asserts that cell-wall deficient bacteria infect the body and evade immune surveillance by promoting such dysregulation, which in turn suppresses the body's immune response.^ For Vitamin D only, 1mcg translates to 40 IU. White Blood Cell: (WBC): A blood cell that does not contain hemoglobin: a blood corpuscle responsible for maintaining the body's immune surveillance system against invasion by foreign substances such as viruses or bacteria.

^ My friend with Sarcoidosis has died, her doctors refused to give her the medications for the Marshall Protocol.
  • Bernie Mac and Sarcoidosis « FOX News Health Blog « FOXNews.com 17 January 2010 12:25 UTC health.blogs.foxnews.com [Source type: General]

^ Doctors believe sarcoidosis results from an abnormal immune response.
  • Sarcoidosis 17 January 2010 12:25 UTC www.cnn.com [Source type: General]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: General]
  • OhioHealth - Sarcoidosis 17 January 2010 12:25 UTC www.ohiohealth.com [Source type: General]
  • Sarcoidosis 17 January 2010 12:25 UTC e.a.cnn.net [Source type: General]
  • MayoClinic.com Health Library - Sarcoidosis 17 January 2010 12:25 UTC www.riversideonline.com [Source type: General]

.Because sarcoidosis can affect multiple organ systems, follow-up on a patient with sarcoidosis should always include an electrocardiogram, ocular examination by an ophthalmologist, liver function tests, serum calcium and 24-hour urine calcium.^ Mouth Sarcoidosis can affect any organ, and the mouth is not exempt.
  • http://www.marshallprotocol.com/forum37/3094.html 17 January 2010 12:25 UTC www.marshallprotocol.com [Source type: FILTERED WITH BAYES]

^ Pulmonary function tests are useful in the initial diagnosis and follow up of patients with sarcoidosis.
  • MERSI Ocular Immunology and Uveitis Foundation| Medical Professionals | Articles | Case Reports 17 January 2010 12:25 UTC www.uveitis.org [Source type: Academic]

^ Skin Eyes Liver Sarcoidosis infrequently affects the following organs: .
  • Sarcoidosis - Medpedia 17 January 2010 12:25 UTC wiki.medpedia.com [Source type: FILTERED WITH BAYES]

.In female patients sarcoidosis is significantly associated with hypothyroidism, hyperthyroidism and other thyroid diseases, hence close surveillance of thyroid function is recommended.^ Are other rheumatological diseases associated with sarcoidosis?

^ Sarcoidosis has been associated with celiac disease.

^ Sinonasal disease in patients with sarcoidosis.
  • Clinical manifestations and diagnosis of sarcoidosis 17 January 2010 12:25 UTC www.uptodate.com [Source type: Academic]

[15]

Prognosis

.The disease can remit spontaneously or become chronic, with exacerbations and remissions.^ For patients with chronic disease (≥2 years), the chances of spontaneous remission are low.

^ Those patients who do not experience remission within 2 yr are likely to have chronic disease.
  • Sarcoidosis: Pulmonary Disorders: Merck Manual Professional 17 January 2010 12:25 UTC www.merck.com [Source type: Academic]

^ While spontaneous remissions occur in nearly two thirds of patients, the course is chronic or progressive in 10% to 30%.
  • USPharmacist.com > Sarcoidosis 17 January 2010 12:25 UTC www.uspharmacist.com [Source type: Academic]

.In some patients, it can progress to pulmonary fibrosis and death.^ Progressive pulmonary fibrosis .
  • Sarcoidosis - July 15, 2004 - American Family Physician 17 January 2010 12:25 UTC www.aafp.org [Source type: Academic]

^ Most patients with symptomatic progressive pulmonary disease will be treated with corticosteroids as well.
  • USPharmacist.com > Sarcoidosis 17 January 2010 12:25 UTC www.uspharmacist.com [Source type: Academic]

^ In some cases, progressive interstitial fibrosis accompanies the scarred granulomas.

.Approximately half of the cases resolve or can be cured within 12–36 months and most within 5 years.^ In most patients, manifestations disappear within a few months or years.
  • Baylor Health Care System: Sarcoidosis 17 January 2010 12:25 UTC www.baylorhealth.edu [Source type: Academic]

^ However, half of all cases do resolve within 12 to 36 months, and most within 5 years.

^ The patients with hilar adenopathy had the best prognosis; 58% improved within 12 months, only 9% progressing to infiltrative phase.
  • Pulmonary sarcoidosis: management. Sharma OP - J Postgrad Med 17 January 2010 12:25 UTC www.jpgmonline.com [Source type: Academic]

.Some cases persist several decades.^ Airway involvement can occur and may result in airflow limitation, persistent cough and, in severe cases, bronchiectasis.
  • Sarcoidosis - July 15, 2004 - American Family Physician 17 January 2010 12:25 UTC www.aafp.org [Source type: Academic]

^ In some cases, the symptoms of sarcoidosis may begin suddenly (acute), sometimes severely, and subside in a relatively short period of time (self limited).
  • CIGNA - Sarcoidosis 17 January 2010 12:25 UTC www.cigna.com [Source type: Academic]

^ In some cases, you may take medication for several years, using as low a dose as possible while still controlling the disease.
  • Sarcoidosis 17 January 2010 12:25 UTC www.cnn.com [Source type: General]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: General]
  • Sarcoidosis 17 January 2010 12:25 UTC edition.cnn.com [Source type: General]
  • OhioHealth - Sarcoidosis 17 January 2010 12:25 UTC www.ohiohealth.com [Source type: General]
  • Sarcoidosis 17 January 2010 12:25 UTC e.a.cnn.net [Source type: General]
  • MayoClinic.com Health Library - Sarcoidosis 17 January 2010 12:25 UTC www.riversideonline.com [Source type: General]

[3] Where the heart is involved, the prognosis is poor.[40] .Patients with sarcoidosis appear to be at significantly increased risk for cancer, in particular lung cancer, malignant lymphomas,[41] and cancer in other organs known to be affected in sarcoidosis.^ Mouth Sarcoidosis can affect any organ, and the mouth is not exempt.
  • http://www.marshallprotocol.com/forum37/3094.html 17 January 2010 12:25 UTC www.marshallprotocol.com [Source type: FILTERED WITH BAYES]

^ Patients with sarcoidosis are at increased risk of sudden death.
  • Echocardiography 17 January 2010 12:25 UTC www2.umdnj.edu [Source type: Academic]

^ The lung is the most frequently affected organ in patients with sarcoidosis.
  • MERSI Ocular Immunology and Uveitis Foundation| Medical Professionals | Articles | Case Reports 17 January 2010 12:25 UTC www.uveitis.org [Source type: Academic]

[42] .In sarcoidosis-lymphoma syndrome, sarcoidosis is followed by the development of a lymphoproliferative disorder such as non-Hodgkin lymphoma.^ Non-Hodgkin lymphoma .
  • Sarcoidosis: Pulmonary Disorders: Merck Manual Professional 17 January 2010 12:25 UTC www.merck.com [Source type: Academic]
  • Sarcoidosis: Pulmonary Disorders: Merck Manual Professional 17 January 2010 12:25 UTC www.merck.com [Source type: Academic]

^ Current thought is that Sarcoidosis develops when the immune system responds to things such as chemicals, viruses, bacteria or dust in the environment, or even to the body's own tissue.
  • Sarcoidosis Disease Information 17 January 2010 12:25 UTC www.disabled-world.com [Source type: FILTERED WITH BAYES]

^ The diagnosis of sarcoidosis relies on clinico-radiographical presentation and evidence of non caseating granulomas on biopsy specimens after appropriate exclusion of other granulomatous disorders [ 3 , 24 ].
  • Orphanet Journal of Rare Diseases | Full text | Sarcoidosis 17 January 2010 12:25 UTC www.ojrd.com [Source type: Academic]

[43] .This may be attributed to the underlying immunological abnormalities that occur during the sarcoidosis disease process.^ The differing incidence across the world may be at least partially attributable to the lack of screening programs in certain regions of the world and the overshadowing presence of other granulolomatous diseases such as tuberculosis , that may interfere with the diagnosis of sarcoidosis where they are prevalent.

^ The disease occurs worldwide and may affect people of either sex, as well as those from any ethnic or age group.
  • Diagnosis of systemic sarcoidosis prompted by orofacial manifestations: A review of the literature -- Fatahzadeh and Rinaggio 137 (1): 54 -- The Journal of the American Dental Association 17 January 2010 12:25 UTC jada.ada.org [Source type: Academic]

^ Blood tests may also show elevated calcium levels and abnormalities in the liver, kidneys and bone marrow (organs which can be affected by sarcoidosis).
  • What is Sarcoidosis 17 January 2010 12:25 UTC www.squidoo.com [Source type: FILTERED WITH BAYES]

[44] .Sarcoidosis can also follow cancer [45] or occur concurrently with cancer.^ Cardiac involvement may precede, follow, or occur concurrently with involvement of the lungs or other organs.

^ Cancer risk in hospitalized sarcoidosis patients: a follow-up study in Sweden.
  • NEJM -- Sarcoidosis 17 January 2010 12:25 UTC content.nejm.org [Source type: Academic]

[46]

See also

References

  1. ^ sarcoidosis at Dorland's Medical Dictionary
  2. ^ a b Syed, J.; Myers, R. (Jan 2004). "Sarcoid heart disease.". Can J Cardiol 20 (1): 89-93. PMID 14968147. 
  3. ^ a b c d Nunes H, Bouvry D, Soler P, Valeyre D (2007). "Sarcoidosis". Orphanet J Rare Dis 2: 46. doi:10.1186/1750-1172-2-46. PMID 18021432. 
  4. ^ Henke, CE.; Henke, G.; Elveback, LR.; Beard, CM.; Ballard, DJ.; Kurland, LT. (May 1986). "The epidemiology of sarcoidosis in Rochester, Minnesota: a population-based study of incidence and survival.". Am J Epidemiol 123 (5): 840-5. PMID 3962966. 
  5. ^ "American Thoracic Society: Statement on Sarcoidosis." Am J Respir Crit Care Med 1999;160:736-755.
  6. ^ a b James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0. 
  7. ^ National Heart, Lung, and Blood Institute: DCI Home: Lung Diseases: Sarcoidosis: Signs & Symptoms Retrieved on May 9, 2009.
  8. ^ Tolaney SM, Colson YL, Gill RR, Schulte S, Duggan MM, Shulman LN, Winer EP. Sarcoidosis mimicking metastatic breast cancer. Clin Breast Cancer. 2007 Oct;7(10):804-10. PubMed PMID: 18021484.
  9. ^ "Sarcoidosis and the Heart". Foundation for Sarcoidosis Research. Accessed 2 Dec 2007. [1]
  10. ^ Anna M.McDivit and Arman T. Askari,"A Middle-aged Man with Progressive Fatigue,"Cleveland Clinic Journal of Medicine 2009; 76(10):564-574 McDivit, A.; Askari, A. (2009). "A middle-aged man with progressive fatigue". Cleveland Clinic journal of medicine 76 (10): 564–574. doi:10.3949/ccjm.76a.08114. PMID 19797455.  edit
  11. ^ Heart. 2006 February; 92(2): 282–288. Doughan, A.; Williams, B. (2006). "Cardiac sarcoidosis". Heart (British Cardiac Society) 92 (2): 282–288. doi:10.1136/hrt.2005.080481. PMID 16415205.  edit
  12. ^ Forensic Science International, Volume 89, Issue 3, Pages 145-153
  13. ^ Rajasenan, V.; Cooper, ES. (Jul 1969). "Myocardial sarcoidosis, bouts of ventricular tachycardia, psychiatric manifestations and sudden death. A case report.". J Natl Med Assoc 61 (4): 306-9. PMID 5796402. 
  14. ^ http://www.labtestsonline.org/understanding/analytes/ace/test.html
  15. ^ a b c d .Antonelli A, Fazzi P, Fallahi P, Ferrari SM, Ferrannini E (August 2006). "Prevalence of hypothyroidism and Graves disease in sarcoidosis". Chest 130 (2): 526–32. doi:10.1378/chest.130.2.526. PMID 16899854. 
  16. ^ Rossman MD, Kreider ME (August 2007). "Lesson learned from ACCESS (A Case Controlled Etiologic Study of Sarcoidosis)". Proc Am Thorac Soc 4 (5): 453–6. doi:10.1513/pats.200607-138MS. PMID 17684288. 
  17. ^ Kettritz R, Goebel U, Fiebeler A, Schneider W, Luft F (October 2006). "The protean face of sarcoidosis revisited". Nephrol. Dial. Transplant. 21 (10): 2690–4. doi:10.1093/ndt/gfl369. PMID 16861724. 
  18. ^ a b Verschueren K, Van Essche E, Verschueren P, Taelman V, Westhovens R (November 2007). "Development of sarcoidosis in etanercept-treated rheumatoid arthritis patients". Clin. Rheumatol. 26 (11): 1969–71. doi:10.1007/s10067-007-0594-1. PMID 17340045. 
  19. ^ Stokes MB, Foster K, Markowitz GS (July 2005). "Development of glomerulonephritis during anti-TNF-alpha therapy for rheumatoid arthritis". Nephrol. Dial. Transplant. 20 (7): 1400–6. doi:10.1093/ndt/gfh832. PMID 15840673. 
  20. ^ Iannuzzi MC (August 2007). "Advances in the genetics of sarcoidosis". Proc Am Thorac Soc 4 (5): 457–60. doi:10.1513/pats.200606-136MS. PMID 17684289. 
  21. ^ Grunewald J, Eklund A, Olerup O (March 2004). "Human leukocyte antigen class I alleles and the disease course in sarcoidosis patients". Am. J. Respir. Crit. Care Med. 169 (6): 696–702. doi:10.1164/rccm.200303-459OC. PMID 14656748. 
  22. ^ Hiramatsu J, Kataoka M, Nakata Y (October 2003). "Propionibacterium acnes DNA detected in bronchoalveolar lavage cells from patients with sarcoidosis". Sarcoidosis Vasc Diffuse Lung Dis 20 (3): 197–203. PMID 14620162. 
  23. ^ Inoue Y, Suga M (2008). "[Granulomatous diseases and pathogenic microorganism]" (in Japanese). Kekkaku 83 (2): 115–30. PMID 18326339. 
  24. ^ Gupta D, Agarwal R, Aggarwal AN, Jindal SK (September 2007). "Molecular evidence for the role of mycobacteria in sarcoidosis: a meta-analysis". Eur. Respir. J. 30 (3): 508–16. doi:10.1183/09031936.00002607. PMID 17537780. 
  25. ^ Almenoff PL, Johnson A, Lesser M, Mattman LH. Growth of acid fast L forms from the blood of patients with sarcoidosis. Thorax 1996;51:530-3. PMID 8711683.
  26. ^ Padilla ML, Schilero GJ, Teirstein AS. Donor-acquired sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2002;19:18-24. PMID 12002380.
  27. ^ Barbour GL, Coburn JW, Slatopolsky E, Norman AW, Horst RL. Hypercalcemia in an anephric patient with sarcoidosis: evidence for extrarenal generation of 1,25-dihydroxyvitamin D. N Engl J Med 1981;305:440-3. PMID 6894783.
  28. ^ a b c Subramanian P, Chinthalapalli H, Krishnan M (September 2004). "Pregnancy and sarcoidosis: an insight into the pathogenesis of hypercalciuria". Chest 126 (3): 995–8. doi:10.1378/chest.126.3.995. PMID 15364785. 
  29. ^ University of Melbourne seminar (2006)."Molecular Mechanisms Driving the Current Epidemic of Chronic Disease"
  30. ^ Porter N, Beynon HL, Randeva HS (2003). "Endocrine and reproductive manifestations of sarcoidosis". QJM 96 (8): 553–61. doi:10.1093/qjmed/hcg103. PMID 12897340. http://qjmed.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=12897340. 
  31. ^ Yu-Lee LY (2002). "Prolactin modulation of immune and inflammatory responses". Recent Prog. Horm. Res. 57: 435–55. doi:10.1210/rp.57.1.435. PMID 12017556. http://rphr.endojournals.org/cgi/pmidlookup?view=long&pmid=12017556. 
  32. ^ Méndez I, Alcocer-Varela J, Parra A (2004). "Neuroendocrine dopaminergic regulation of prolactin release in systemic lupus erythematosus: a possible role of lymphocyte-derived prolactin". Lupus 13 (1): 45–53. doi:10.1191/0961203304lu487oa. PMID 14870917. http://openurl.ingenta.com/content/nlm?genre=article&issn=0961-2033&volume=13&issue=1&spage=45&aulast=Méndez. 
  33. ^ Papadopoulos KI, Hörnblad Y, Liljebladh H, Hallengren B (March 1996). "High frequency of endocrine autoimmunity in patients with sarcoidosis". Eur. J. Endocrinol. 134 (3): 331–6. doi:10.1530/eje.0.1340331. PMID 8616531. 
  34. ^ Romagnani S (June 1997). "The Th1/Th2 paradigm". Immunol. Today 18 (6): 263–6. doi:10.1016/S0167-5699(97)80019-9. PMID 9190109. http://linkinghub.elsevier.com/retrieve/pii/S0167569997800199. 
  35. ^ "eMedicine - Hypersensitivity Reactions, Delayed : Article by Walter Duane Hinshaw". http://www.emedicine.com/MED/topic1100.htm. Retrieved 2008-09-18. 
  36. ^ Morell F, Levy G, Orriols R, Ferrer J, De Gracia J, Sampol G (April 2002). "Delayed cutaneous hypersensitivity tests and lymphopenia as activity markers in sarcoidosis". Chest 121 (4): 1239–44. doi:10.1378/chest.121.4.1239. PMID 11948059. http://www.chestjournal.org/cgi/pmidlookup?view=long&pmid=11948059. 
  37. ^ New York Times article, May 24, 2007
  38. ^ White, E.S.; Lynch Jp, 3rd (June 2007). "Current and emerging strategies for the management of sarcoidosis". Expert Opinion on Pharmacotherapy 8 (9): 1293–1311. doi:10.1517/14656566.8.9.1293. PMID 17563264. 
  39. ^ "Dosing Considerations"
  40. ^ J.Syed and R. Myers, "Sarcoid Heart Disease," Can J Cardiol. 2004 Jan;20(1):89-93.
  41. ^ Karakantza, M.; Matutes, E.; MacLennan, K.; O'Connor, NT.; Srivastava, PC.; Catovsky, D. (Mar 1996). "Association between sarcoidosis and lymphoma revisited.". J Clin Pathol 49 (3): 208-12. PMID 8675730. 
  42. ^ J. Askling; et al., "Increased Risk for Cancer Following Sarcoidosis," Am. J. Respir. Crit. Care Med., Volume 160, Number 5, November 1999, 1668-1672
  43. ^ Kornacker, M.; Kraemer, A.; Leo, E.; Ho, A. (2002). "Occurrence of sarcoidosis subsequent to chemotherapy for non-Hodgkin's lymphoma: report of two cases". Annals of hematology 81 (2): 103–105. doi:10.1007/s00277-001-0415-6. PMID 11907791.  edit
  44. ^ Suvajdzic, N.; Milenkovic, B.; Perunicic, M.; Stojsic, J.; Jankovic, S. (2007). "Two cases of sarcoidosis-lymphoma syndrome". Medical Oncology 24 (4): 469. doi:10.1007/s12032-007-0026-8. PMID 17917102.  edit
  45. ^ Yao, M.; Funk, G.; Goldstein, D.; Deyoung, B.; Graham, M. (2005). "Benign lesions in cancer patients: Case 1. Sarcoidosis after chemoradiation for head and neck cancer.". Journal of clinical oncology : official journal of the American Society of Clinical Oncology 23 (3): 640–641. doi:10.1200/JCO.2005.02.089. PMID 15659510.  edit
  46. ^ doi:10.1378
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Up to date as of January 14, 2010

From Wikiversity

.Sarcoidosis is a multi system granulomatous disorder affecting predominantly young adults although may affect adults of any age.^ Sarcoidosis is a systemic granulomatous disease shich most commonly affects black, young adults.
  • Sarcoidosis 17 January 2010 12:25 UTC uuhsc.utah.edu [Source type: FILTERED WITH BAYES]

^ It was known that he had sarcoidosis , a multi-system immune disorder that primarily affects the lungs.
  • Bernie Mac, pneumonia, and sarcoidosis | KevinMD.com 17 January 2010 12:25 UTC www.kevinmd.com [Source type: General]

^ Sarcoidosis commonly affects young and middle-aged adults.
  • USPharmacist.com > Sarcoidosis 17 January 2010 12:25 UTC www.uspharmacist.com [Source type: Academic]

.It is particularly likely to affect the respiratory tract where it may cause mediastinal lymph node enlargement , and granulomatous inflammation of alveoli (air sacs).^ It is particularly likely to affect the respiratory tract where it may cause mediastinal lymph node enlargement , and granulomatous inflammation of alveoli (air sacs).
  • Sarcoidosis - Wikiversity 17 January 2010 12:25 UTC en.wikiversity.org [Source type: Reference]

^ Lymph Nodes -- Enlargement of various lymph nodes can occur.
  • Sarcoidosis 17 January 2010 12:25 UTC www.pcca.net [Source type: FILTERED WITH BAYES]

^ Mediastinal lymph nodes .
  • Sarcoidosis - July 15, 2004 - American Family Physician 17 January 2010 12:25 UTC www.aafp.org [Source type: Academic]

.In a minority of cases it may lead to progressive thickening and fibrosis of alveolar septa, and hence impaired gas exchange.^ In a minority of cases it may lead to progressive thickening and fibrosis of alveolar septa, and hence impaired gas exchange.
  • Sarcoidosis - Wikiversity 17 January 2010 12:25 UTC en.wikiversity.org [Source type: Reference]

^ Gas exchange at a given degree of volume restriction is different in sarcoidosis and idiopathic pulmonary fibrosis.
  • Clinical manifestations and diagnosis of sarcoidosis 17 January 2010 12:25 UTC www.uptodate.com [Source type: Academic]

^ Granuloma may then be responsible for its own perpetuation and for progression to fibrosis although some modulation must occur since fibrosis does not always accompany the granulomas of sarcoidosis.

.Symptoms of sarcoidosis include cough, dyspnoea (shortness of breath) and occasionally chest pain.^ Generally, shortness of breath and a cough that will not go away are among the first symptoms of sarcoidosis.

^ My symptoms include chronic coughing, shortness of breath, chronic fatigue & joint pain in my hands and wrists.
  • Sarcoidosis Awareness - The Petition Site 17 January 2010 12:25 UTC www.thepetitionsite.com [Source type: General]

^ Symptoms common in sarcoidosis include the following .
  • Sarcoidosis Symptoms 17 January 2010 12:25 UTC www.symptoms-4u.com [Source type: FILTERED WITH BAYES]

.Other manifestations of sarcoidosis include granulomatous inflammation of the liver, cardiac conduction abnormalities, painful skin lesions (erythma nodosum), and eye disease (uveitis).^ Definition of Sarcoidosis: Sarcoidosis is a disease of unknown cause in which inflammation occurs in the lymph nodes, lungs, liver, eyes, skin, and/or other tissues.
  • Sarcoidosis Medications | Drugs.com 17 January 2010 12:25 UTC www.drugs.com [Source type: General]

^ Skin lesions Erythema nodosum Lupus pernio Other lesions .
  • Sarcoidosis: A Primary Care Review - December 1998 - American Academy ofFamily Physicians 17 January 2010 12:25 UTC www.aafp.org [Source type: Academic]

^ Are other rheumatological diseases associated with sarcoidosis?

.Treatment is usually only provided where significant impairment is present.^ Treatment is usually only provided where significant impairment is present.
  • Sarcoidosis - Wikiversity 17 January 2010 12:25 UTC en.wikiversity.org [Source type: Reference]

^ Unfortunately, none of these has provided reliable treatment, and there can be significant side effects such as an increased risk of reactivating latent tuberculosis .
  • Sarcoidosis encyclopedia topics | Reference.com 17 January 2010 12:25 UTC www.reference.com [Source type: Academic]
  • Bing Health Article - Sarcoidosis 17 January 2010 12:25 UTC www.bing.com [Source type: Academic]

^ The material on the QualityHealth Web site is for informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment provided by a physician or other qualified health provider.
  • Sarcoidosis - Alternative Medicine Report 17 January 2010 12:25 UTC www.qualityhealth.com [Source type: FILTERED WITH BAYES]
  • Sarcoidosis - Health Information 17 January 2010 12:25 UTC www.qualityhealth.com [Source type: FILTERED WITH BAYES]

.Standard treatment is based on the use of corticosteroids (prednisone or prednisolone).^ Corticosteroids, most commonly prednisone, have been the standard treatment for many years.
  • Sarcoidosis Support Group - DailyStrength 17 January 2010 12:25 UTC www.dailystrength.org [Source type: General]

^ Standard treatment is based on the use of corticosteroids (prednisone or prednisolone).
  • Sarcoidosis - Wikiversity 17 January 2010 12:25 UTC en.wikiversity.org [Source type: Reference]

^ The usual treatment is prednisone, a corticosteroid.
  • MOAA: Sarcoidosis 17 January 2010 12:25 UTC www.moaa.org [Source type: Academic]


Simple English

Sarcoidosis is a granulomatous disorder of unkonwn etiology (cause) that can affect multiple organs, although the Lungs are the most frequent site of involvement. Corticosteroids such as Prednisone are often used to treat sarcoidosis. In some cases, the immuosuppressive drug methotrexate may be also used. Antimalirial drugs have also been used.[1] It may involve the brain. If it does, it is referred to as Neurosarcoidosis. In some cases, pulmonary fibrosis is a complication of sarcoidosis.

References


Citable sentences

Up to date as of December 26, 2010

Here are sentences from other pages on Sarcoidosis, which are similar to those in the above article.








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