Sarcoidosis, diagnosis and treatment

Content

  • Sarcoidosis, manifestations of sarcoidosis
  • How is the diagnosis of sarcoidosis
  • How is the treatment of sarcoidosis



  • 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,
    except adrenal.

    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;
    • postsarkoidozny
      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, diagnosis and treatment
    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
    pelvis.

    Magnetic resonance imaging with informative
    sarcoidosis, central nervous system, liver and heart. lesions
    many organs in sarcoidosis confirmed by scanning with gallium and
    technetium.

    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.

    "Golden
    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.

    Before
    appointments hormone therapy in the watchful waiting period may
    be assigned to vitamin E and N-acetylcysteine ​​(NAC, Fluimucil).

    indications
    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.

    Sarcoidosis, diagnosis and treatment
    Patients with
    manifestations of the disease such as skin lesions, anterior uveitis, or
    cough apply topical hormones (creams, drops, sprays
    respectively).

    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.

    Antimalarial
    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.

    AT
    resistant to hormone therapy cases also prescribe azathioprine,
    cyclophosphamide, cycloserine A horambutsil, colchicine, allopurinol,
    isotretinoin, thalidomide.

    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.

    physiotherapy
    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.

    Of
    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).

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