SARCOIDOSIS

also called sarcoid, Besnier-Boeck disease or Besnier-Boeck-Schaumann disease, is a disease in which abnormal collections of chronic inflammatory cells (granulomas) form as nodules in multiple organs. The cause of sarcoidosis is unknown. The granulomas that appear are usually not of the necrotizing variety and are most often located in the lungs or the lymph nodes, but virtually any organ can be affected.

[Exact cause is unknown]; exposure to an environmental, occupational or infectious agent Alteration to the immune response Accumulation of monocytes, macrophages & activated Tlymphocytes Noncaseating granulomatous formation with increased production of key inflammatory mediators Inc. macrophages &CD-4 helper T-cell activation Accelerated systemic inflammation which may be symptomatic or asymptomatic

Many people with sarcoidosis get better without treatment. You may also have any of the following: Medicines: Steroids: (prednisone or methylprednisolone) help slow down immune system and reduce the symptoms of sarcoidosis. Cytotoxic medicines: decrease redness, pain, and swelling, and help slow down your immune system. NSAIDs: decrease swelling and pain Acetaminophen: decreases pain and fever. Antimalarial drugs: (Hydroxychloroquine) is
useful for skin sarcoidosis

A physical exam may show the following: Abnormal breath sounds (such as rales) Enlarged liver Enlarged spleen Enlarged lymph glands Rash Sarcoidosis can be hard to diagnose since it mimic cancer. Tests that may be done may include:

Surgery: surgery to remove granulomas that cause severe signs and symptoms. Caregivers may use lasers (light beams) or dermabrasion to remove or smooth skin lesions. Nursing intervention in clients with sarcoidosis is the same as that in clients with other restrictive lung diseases and hypoxemia. Access for drug side effects, especially adverse responses to corticosteroids (such as weight gain, change in mood, and development of DM). Also assess for manifestations of improvement, such as increased exercise tolerance, disappearance of initial assessment findings, improvement of pulmonary function studies, and better oxygenation. If assessment findings worsen, document them and notify the physician. Assess at 3- to 6-month intervals to reevaluate decisions about therapy. Specific treatments may require laboratory monitoring. Calcium metabolism (hypercalcemia and/or hypercalcinuria; Serum calcium Increased exogenous vitamin D from diet or sunlight exposure may exacerbate hypercalcemia.

Chest x-ray Biopsy Blood testsinc. Cl, ACE & ESR Bronchoscopy -- examines the inside of your lungs CT scan, MRI, or other imaging tests ECG (electrocardiogram) Lung function tests Gallium scanninggallium-67 collects @ places in the body affected by sacrcoidosis Kveim test Slit-lamp exam Diascopy-pressing skin lesions using glass plate
Eyes: Granulomas in the eyes can cause pain, swelling, and vision changes. Heart: chest pain, abnormal heartbeats, or the heart may stop beating. Lungs: cough, trouble breathing, and hemoptysis. Muscles, bones, and joints: joints, muscles, and bones may be painful, swollen, red, and warm. Skin: Granulomas may appear as flat or raised lumps in skin, erythema nodosum Other organs: Granulomas in the liver may cause skin to turn yellow and may cause kidney stones when found in the kidneys. Granulomas in the intestines may block the passage of food or blood and cause pain and bleeding. swollen, painful lymph nodes in your neck, armpits, or groin.