Sarcoidosis, manifestations of sarcoidosis
Sarcoidosis - a disease of unknown cause, characterized
the formation of specific nodules. Dominated intrathoracic
manifestations of sarcoidosis, however, described the defeat of all organs and systems,
The cause of sarcoidosis is considered a combination of genetic, environmental, infectious and immunological factors.
One of the most characteristic manifestations of sarcoidosis any type of flow
It is fatigue. Patients often note only increased
fatigue in the absence of any signs of disease at inspection.
Dutch clinicians are 4 types of fatigue in sarcoidosis:
- Morning fatigue, when the patient can not get out of bed;
- fatigue during the day, forcing the patient to accustom themselves to the intermittent pace of activity during the day;
- Evening weakness when the patient wakes up in the morning with adequate life-energy and feel "squeezed" in the evening;
Chronic fatigue syndrome is characterized by muscle pain,
fatigue, weakness, and depression in the absence of external
signs of the disease.
Chest pain is a common
and unexplained feature of sarcoidosis. It has a different
localization is not associated with the act of breathing is sometimes feels
on the border between pain and discomfort.
The skin can be detected
purple-red, dense nodes which occur at the most
shins. When the feeling they can be painful, and for extinction
Process in their place a long time is saved gray-purple
changes in skin color.
Inflammation of the joints are transient in nature, atypical strain.
How is the diagnosis of sarcoidosis
Sarcoidosis is a "diagnosis of exclusion", because it is not
infectious or malignant process. Currently, the main
method of radiation diagnosis of sarcoidosis is an X-ray
high-resolution computed tomography.
Among the others
diagnostic methods of sarcoidosis (especially at the initial examination
or progression of the process) is shown holding ultrasound
liver examinations, kidney, heart, thyroid gland and of the small
Magnetic resonance imaging with informative
sarcoidosis, central nervous system, liver and heart. lesions
many organs in sarcoidosis confirmed by scanning with gallium and
A study of respiratory function (recording of the curve
Feed-forced expiratory volume) in sarcoidosis in the early stages
identifies violations in the respiratory system.
Compulsory component of initial and annual survey of patients with sarcoidosis is the ECG.
standard "diagnosis of sarcoidosis was the biopsy.
The material can be taken from various bodies - biopsy
limafticheskih peripheral nodes, skin, spleen, salivary gland,
liver, etc. Most often, it is the lungs, hilar lymph
nodes and pleura are targets for sampling tissues.
How is the treatment of sarcoidosis
International experience shows that in 50-70% of cases
newly revealed sarcoidosis gives spontaneous remission (disappearance of symptoms) that no
known today, treatment does not alter the natural course of the disease.
appointments hormone therapy in the watchful waiting period may
be assigned to vitamin E and N-acetylcysteine (NAC, Fluimucil).
to the top of the overall treatment of hormone action is the increase
signs of the disease, an increase in the shadows on chest radiograph and a decrease
vital capacity and diffusion capacity of the lungs, heart involvement
(Arrhythmias or conduction), neurological lesion (for
except for an isolated facial paralysis), eye disease, and
constantly elevated blood calcium levels.
manifestations of the disease such as skin lesions, anterior uveitis, or
cough apply topical hormones (creams, drops, sprays
For the majority of patients with detected
intrathoracic changes expedient expectant management with
control on the 3rd and 6th months (X-rays, blood tests, calcium
Blood and urine).
Inhaled hormones prescribed as
first-line agents, or at the stage of the total waste hormones
Actions, or patients with intolerance systemic hormones.
It noted the expediency of successive and combined
use of systemic and inhaled hormones.
drugs - chloroquine and hydroxychloroquine have potential side
effect on the retina, which limits their use, but they
not dangerous, if the daily dose not exceeding 250 mg. higher
dosage requires monitoring by an ophthalmologist. known allergic
response to these drugs, they are also contraindicated in pregnancy.
Methotrexate - widely used in chronic and resistant to the hormones sarcoidosis.
resistant to hormone therapy cases also prescribe azathioprine,
cyclophosphamide, cycloserine A horambutsil, colchicine, allopurinol,
Plasmapheresis is recommended in patients with
hormone-dependent, poor tolerance of hormones,
comorbidities (diabetes, gastric ulcer
and duodenal ulcer, etc.)., with relapsing course. spend
2-5 treatments with an interval of 5-8 days.
methods are widely used in the treatment of sarcoidosis - is the EHF,
phonophoresis with hydrocortisone in the chest, with ultrasound
hydrocortisone in the scapular region, inductothermy, laser therapy,
Aloe electrophoresis with novocaine.
unloading diet therapy
for a long time used in Russia at the I and II X-ray
stages of pulmonary sarcoidosis. It noted its immunomodulating influence
stimulation of the adrenal cortex. The combination with hormonal
treatment. The diet is recommended to use a bean, basil,
grenades, sea kale, nuts, sea buckthorn fruit, raw seed
sunflower, black chokeberry fruits and blackcurrant.
phytotherapeutic agents can recommend the plants collection: pick
equal parts herb Knotweed (knotweed), oregano herb leaf
sage, marshmallow root, calendula flowers, plantain leaf. Mix. one
Art. spoon collection to fill a thermos, pour 250 ml of boiling water, close
thermos, insist 30 minutes. Strain, Take 1 / 4-1 / 3 cup 3
times a day for 30 minutes before eating. Course - 45 days. After 3 weeks course
can be repeated. In a break between courses can be taken tincture
Rhodiola rosea 25 drops 2 times a day - in the morning and in the afternoon (for
consultation with the doctor).