Sarcoidosis

Sarcoidosis is an inflammatory disease that affects multiple organs in the body, but mostly the lungs and lymph glands. In people with sarcoidosis, abnormal masses or nodules (called granulomas) consisting of inflamed tissues in certain organs of the body. These granulomas may alter the normal structure and possibly the function of the affected organ(s).

Sarcoidosis in the lungs is called pulmonary sarcoidosis. It causes small lumps of inflammatory cells in the lungs. These lumps are called granulomas and can affect working of  the lungs. The granulomas generally heal and disappear on their own. But, if they do not heal, the lung tissue can remain inflamed and become scarred and stiff. This is called pulmonary fibrosis. It changes the structure of the lungs and can affect your breathing.

Nobody knows what causes sarcoidosis, although there are a number of theories about various viruses or bacteria (some related to TB) or molds/dust exposures.  Sarcoidosis is not contagious.  There are likely multiple pathways which ultimately lead to a similar appearing disease.

With background of appropriate medical history and physical exam, following tests are helpful in diagnosis of Sarcoidosis:

Chest X-ray: Chest X-rays may show important information about the size, shape, and location of the lungs, bronchi (large breathing tubes), and mediastinum (area in the middle of the chest separating the lungs).

CT scan: A CT scan shows detailed images of any part of the body, including the lungs. CT scans are more detailed than regular X-rays. In sarcoidosis it can be useful in diagnosis of lung involvement, monitoring of  disease progression, and evaluation of response to the treatment.

Pulmonary function tests: These are tests that help to measure the lungs’ ability to move air in and out of the lungs. The tests are usually done with special machines into which the person must breathe.

Blood tests These can be used to check the amount of carbon dioxide and oxygen in the blood, evaluate liver and kidney function, and look for infection and other diseases.

Bronchoscopy A long, thin, flexible tube with a light at the end is put down the throat and into the lungs. This lets the doctor to view the bronchi, the main airways of the lungs. It is done to help evaluate and diagnose lung problems. Lung tissue samples (biopsies) and lung washings (lavage) that remove cells from the lungs can be done through the bronchoscope.

Lung biopsy: A test in which a small piece of tissue, cells, or fluid from the lungs is taken out and checked under a microscope.

Treatment is generally done to control symptoms and improve the function of organs affected by the disease. Steroid medicine, such as prednisone, may help reduce inflammation. It can be taken by mouth or inhaled. Other medicines, such as methotrexate, may be used in severe cases or if steroids don’t work.

In many cases, no treatment is needed for pulmonary sarcoidosis. Different treatments work better for different people. Sometimes more than one treatment is used. Most medicines used to treat sarcoidosis suppress the immune system.

You may also join a specialized rehab program at asthma bhawan that includes education, exercise, and support. In severe cases, which are not common, oxygen therapy and even lung transplant may be needed.

Good health practices include:

• Getting regular check-ups with your health care provider.
• Eating a well-balanced diet with a variety of fresh fruits and vegetables.
• Drinking 8 to 10 8-ounce glasses of water a day.
• Getting 6 to 8 hours of sleep each night.
• Exercising regularly, and managing and maintaining your weight.
• Quitting smoking.
• Avoiding exposure to dust, chemicals, fumes, gases, toxic inhalants and other substances that can harm your lungs.
• Avoiding excessive amounts of calcium-rich foods (such as dairy products, oranges, canned salmon with bones), vitamin D and sunlight. Daily sunbathing is an example of excessive sunlight and should be avoided; sunlight received from activities of everyday living is acceptable. (The advice in this bullet point is limited to patients with high blood or urine levels of calcium.)