Sarcoidosis is a multisystem disease that can be seen in various parts of the body. This disease mainly affects the lungs and the lymph nodes in the mediastinum and the hilar regions. The other organs which can be affected are the skin, liver, eye.
This disease is mostly seen in patients who are 20 – 50 years old.
Sarcoidosis can be defined by the presence of non-caseating granulomas in different types of tissues or organs.
Although there is no cure for Sarcoidosis, this disease gets cured on its own in some cases, and in some Sarcoidosis, it may last for years and cause organ damage in severe cases.
What is Sarcoidosis?
Sarcoidosis is an immune mediated and multiorgan disease in which inflammation of cells that is the formation of granulomas is seen in various regions of our body. Sarcoidosis is a disease that reflects our body’s immunity response. This disease more commonly affects the lungs and the lymph nodes.
In the lungs, Sarcoidosis is called pulmonary Sarcoidosis. It causes inflammation of lung cells. If the inflammation does not get settled, the lung tissue will remain inflamed and will be stiff, leading to pulmonary fibrosis and the structure of the lung and the breathing pattern will get affected.
When Sarcoidosis is affected by the lymph nodes, which is very common for this disease, approximately 90% of people get affected on lymph nodes in Sarcoidosis. As lymph nodes are the glands which are found all over the body. They store and make white blood cells.
When Sarcoidosis affects the lymph nodes, inflammation is seen in the gland all over the body. It gets enlarged, discrete and eventually, the lymph nodes get calcified.
What Causes Sarcoidosis ?
The cause of Sarcoidosis is still unknown. In spite of that, there are a few factors that affect the pathogenesis of this disease:
1. Environmental factors: Environment can be responsible for the cause of this disease. Environmental agents: infectious or non-infectious can both be possibly responsible for this disease. Various types of bacteria, viruses can play a role in infecting a particular organ or tissue leading to Sarcoidosis.
Examples: mycobacterium, Propionibacterium acnes, spirochetes, fungi, Rickettsia.
2. Age and Sex: Although Sarcoidosis can be caused at any age but most commonly this disease is seen in patients of around 20-50 years. On the other hand, this disease is more prominently seen in females than in males.
3. Chemicals: Besides bacterias and viruses, chemicals can also affect the pathogenesis of this disease. Metals like titanium, aluminium, beryllium, and some other rare earth metal are responsible for the inflammation of granulomas.
4. Genetic Factors: If a family membrane is affected by Sarcoidosis then it’s more likely that it gets affected to other family members. Specific types of HLA genotypes that is HLA-A1 and HLA-B8 which are responsible for causing Sarcoidosis.
5. Immunological Factors: This is mainly responsible for the pathogenesis of this disease. The environmental agents that is infectious of non-infectious; trigger the cell-mediated immune response and binds with the unknown antigen in a genetically suspected host.
The process by which how exactly Sarcoidosis is affected in our body is as follows:
1. The basic characteristic feature of this disease is inflammation of the tissue or the organ which leads to the formation of sarcoid granulomas.
2. The sarcoid granulomas develop as a cell-mediated immune response to an unknown and unidentified antigen.
3. This unknown antigen is taken up by the antigen presenting cells.
4. This antigen presently cell goes to the unknown antigen to the CD4+ helper T cells which directly results in antigen driven proliferation of CD4+ helped T cells, and then the activated monocytes are accumulated.
5. CD4+ helper T cells release several cytokines such as interferons and interleukins.
Now by the in general increase in the cytokines, more and more number of helper T cells and the activated monocytes are accumulated in the affected region and it leads to the formation of a sarcoid granulomas.
What are the Symptom OF Sarcoidosis?
In some cases, patients do not have any kind of symptoms. But a common symptom of this disease can be inflammation of the tissue or a particular organ. Symptoms seen in Sarcoidosis can be internal respiratory systems such as shortness of breath, breathlessness, chest pain, coughing, hemoptysis.
The other symptoms involved are fever, fatigueness, loss of weight, sweating at night time, anorexia: eating disorder, increase in ACE (Angiotensin-converting enzyme), hypercalcemia due to the excess amount of vitamin D production.
How is Sarcoidosis Diagnosed?
There is no proper way to diagnose Sarcoidosis as the answer of how the disease is caused is still unknown to us. Still for the diagnosis purpose doctors use many ways to analysis if there is any sign of this disease. Some are as follows :
1. Kviem test: This test is used to diagnose the Sarcoidosis of the skin. In this test, injection is given to the patient which is derived from the sarcoid tissue and is injected into the skin. Then the doctor sees if there is any kind inflammation on that surface or not. If a lump of inflammation is seen then the person is diagnosed by skin Sarcoidosis.
2. Chest X-rays: They are taken to check if any kind of clumping is seen or not.
3. HRCT scan: This is done so that the doctor can have a detailed and more precise view of the lymph nodes, the lungs, or the other suspected part. This diagnosis is more accurate than this X-rays.
How is Sarcoidosis Treated?
As the cause is still unknown, the treatment to it is also not particular. However, Sarcoidosis is a disease where, if not very severe, it can get cured on its own, whereas if the sarcoid granulomas is severe it may lead to organ dysfunction that is calcification of the particular tissue or the organ.
Though this disease is not fatal, less than 3% of patients die of pulmonary or cardiac dysfunction. Doctors usually give steroid therapy to approximately 60-70% of patients suffering from Sarcoidosis.
The most important thing is the awareness of the patient. The patient should have a regular visit to the doctor to be guided in the right path and have a proper treatment.
The patient should have a proper well-defined, and well-balanced diet as this plays a very important role in developing immunity. If the patient is into drinking or smoking, they should immediately stop it as it may affect abruptly to the lymph nodes and the lungs.