📆 Today is World Awareness
#Sarcoidosis Day
Every year on April 13th, World Sarcoidosis Awareness Day draws attention to this inflammatory disease. The day also encourages those who have this condition to support one another and educate others about living with sarcoidosis.
Sarcoidosis is a multisystem inflammatory disorder of unknown cause, primarily affecting young adults worldwide. It is characterized by non-caseating granulomas, most commonly involving the lungs (bilateral hilar lymphadenopathy and reticular opacities), skin, eyes, and joints, but can affect virtually any organ including the heart, CNS, kidneys, and musculoskeletal system.
Pathogenesis: It involves a dysregulated immune response with activated T-cells (often inverted CD4/CD8 ratio), granuloma formation (macrophages, epithelioid cells, giant cells, lymphocytes), B-cell hyperreactivity, hypergammaglobulinemia, and elevated TNF and ACE levels. Both genetic and environmental factors contribute.
Pulmonary Sarcoidosis Management:
◦ Often asymptomatic and self-limiting; many patients experience spontaneous remission and require no treatment.
◦ Asymptomatic patients: monitor with symptoms, chest X-ray, and pulmonary function tests every 3–6 months.
◦ Symptomatic or progressive disease (stage II–III): Oral glucocorticoids (0.3–0.6 mg/kg for 4–6 weeks), followed by slow taper over 6–8 months to 10–20 mg/day. Maintenance steroids are usually not required.
◦ Steroid-sparing agents: methotrexate, azathioprine, infliximab, leflunomide, or antimalarials.
◦ End-stage lung disease: lung transplantation (requires lifelong immunosuppression).
Prognosis:
◦ Generally favorable; the disease resolves spontaneously in many cases.
◦ Poor prognostic factors: extensive chest involvement, extrapulmonary disease, pulmonary hypertension.
◦ About 20% of patients develop functional impairment.
◦ Overall mortality: 3–5% (higher in untreated severe cases).
◦ Highest mortality observed in African American women over age 50.