2.13 Sarcoidosis
Pulmonary system review for the USMLE Step 1 Exam
- Sarcoidosis is a multisystem inflammatory disorder with non-caseating granulomas in various organs
- Most commonly affects the lungs and causes restrictive lung disease
- Classic patient is a young black female in her 20-30s, but can affect any gender or race
- Symptoms vary depending on which organs are affected, and can include uveitis, skin lesions, joint pain, and swollen lymph nodes
- Bilateral hilar lymphadenopathy is a classic chest X-ray finding
- Restrictive lung pattern on spirometry with normal FEV1/FEV ratio and decreased total lung capacity
- Bells palsy can be a rare symptom caused by inflammation of the facial nerve (CN VII) and external compression by granulomatous mass
- Non-progressive sarcoidosis doesn't need treatment, but patients with respiratory symptoms or bells palsy can be given immunosuppressants like corticosteroids or methotrexate.
