Sarcoidosis of the lung: symptoms and treatment, causes, prevention
What is this - the term "sarcoidosis" refers to a systemic disease of various organs, for which inflammatory tissue damage is typical, followed by the formation of a cluster of pathological cells, the so-called granulomas.
One of the most common types of sarcoidosis is sarcoidosis of the lung, which is also called Beck's sarcoidosis or Bénie-Beck-Schauman disease.
Sarcoidosis of the lung is diagnosed in more than 90% of cases of sarcoidosis, although it is rarely isolated and combined with an identical lesion of lymph nodes or skin.
According to statistical reports, this disease is most common among people in Northern Europe, as well as in African Americans and Asians. Mostly women are sick before the age of 40.To date, the etiology of the disease is not fully understood. The main reasons doctors consider heredity, infection, pathology of the immune system.
Sarcoidosis of the lung exists in several forms, which simultaneously determine the stage of the disease as well:
The mediastinal-pulmonary form is a lesion of the intrathoracic lymph nodes. This occurs along with the infiltration of lung tissue, as well as bilateral focal or miliary dissemination.
The pulmonary form represents the third stage of the disease. In this situation, the damage becomes more severe. Against the background of the formation of conglomerates, the appearance of pneumosclerosis and emphysema is documented.
Also, lung sarcoidosis is classified according to how fast it progresses.
In this case, isolated:
Sarcoidosis of the lungs in most cases develops gradually. The first symptoms are felt by fever, joint aches, and sleep disturbances. A person feels constant fatigue and a breakdown. There is a loss of appetite and, as a consequence, quite a significant weight loss.
The presence of signs of lung sarcoidosis also depends on the stage of development of the disease. So, for the mediastinal-pulmonary form, cough and shortness of breath are common, which are combined with pain in the sternum.
Also with this form can be observed lesions of the skin, parotid and salivary glands, lymph nodes. The intramammary form is characterized by pain in the chest area, the presence of wheezing and coughing. These symptoms are combined with a high body temperature. Also at this stage, the nodal erythema of the skin is often diagnosed.
With a pulmonary form, coughing and shortness of breath increases, sputum is added to them, sometimes with an admixture of blood. Also, the work of all organs and systems worsens, in particular, signs of cardiopulmonary insufficiency develop.
Diagnosis of the disease is based on the clinical picture, as well as a detailed examination of the patient's anamnesis and its heredity. Then a general blood test is performed. In sarcoidosis there are some changes in it, namely: leukocytosis, high ESR, eosinophilia, lymphopenia.
Patients with suspected pulmonary sarcoidosis are advised to undergo a series of procedures. First of all, CT of lungs and MRI.These studies determine focal dissemination, increases in the area of lymph nodes. Also, it is not superfluous to perform bronchoscopy.
The most accurate diagnosis, confirming or disproving the presence of lung sarcoidosis, gives a histological analysis. It is carried out over a biopsy, which is withdrawn during bronchoscopy, transthorcal puncture or biopsy. In addition, high reliability is shown by the application of the so-called Kveim test. This assay involves the administration of a sarcoid antigen subcutaneously.
After about 3 weeks, the site of the injection is excised and a histological analysis is performed with the sample. With a positive result of the Kveim test, development of a standard sarcoid granuloma is noted.
It is not uncommon for cases where sarcoidosis of the lungs occurs absolutely without any symptoms. As a rule, in such a situation, the disease is diagnosed during a prophylactic X-ray study.
Given the long development of pulmonary sarcoidosis, the patient needs constant medical supervision for 6-8 months. The purpose of specific types of medication depends on the stage at which the disease occurs.
All patients on dispensary registration are divided into several groups:
There are no specific drugs that fight sarcoidosis for today, unfortunately. This is because the etiology of the disease has not been established.
In most cases, sarcoidosis proceeds in good order. At the same time, many of its forms are characterized by the absence of any obvious symptoms and do not give a person great discomfort.
Approximately 30% of patients with sarcoidosis of the lungs go into a chronic stage. In this case it is necessary to regularly monitor the doctor and prevent possible respiratory failure, which is often formed in a similar course of the disease.
In a number of patients, recovery is possible after the first successful course of treatment. In others, the disease can reminisce throughout its life with numerous remissions.
The prognosis for sarcoidosis of the lungs is significantly improved if the disease was detected in the early stages, which is why it is recommended not to neglect the prophylactic radiology procedures.
In sarcoidosis, complications can occur that mostly affect the airways and the cardiovascular system. To such complications, in particular belongs to the syndrome of the pulmonary heart. In this condition, the walls of the heart thicken, its blood supply is disturbed. As a result, heart failure may develop.
Lung emphysema, broncho-obstructive syndrome is also a common complication of lung sarcoidosis. The process of fibrotic sarcoid granulomas in about 10% of cases can lead to interstitial pneumosclerosis. Sometimes, against the background of sarcoidosis, tuberculosis of the lungs may appear, or an infection may occur.
Preventative measures in sarcoidosis include the implementation of healthy lifestyle rules. In order to prevent a possible occurrence of the disease, it is recommended to stop smoking.
Also it is necessary to limit to a minimum the use in food of products with a different sort of unnatural additives, to limit contact with harmful chemical substances.
There is a special risk for sarcoidosis in people with already diagnosed pathologies of the immune system. Such people should be the most attentive to their health and, with the slightest suspicion, go to a medical facility.
People who have already diagnosed sarcoidosis should also take care of their health in order to prevent a possible complication of the disease. One of the important rules for such patients is the restriction of calcium intake.
Since sarcoidosis causes pathological formation of stones in the bladder, food rich in calcium will only accelerate this process. For the same reason, it is worth limiting your stay in the sun: sunbathing contributes to the increased production of vitamin D, which, in turn, increases the content of calcium in the blood.
One of the most common types of sarcoidosis is sarcoidosis of the lung, which is also called Beck's sarcoidosis or Bénie-Beck-Schauman disease.
Sarcoidosis of the lung is diagnosed in more than 90% of cases of sarcoidosis, although it is rarely isolated and combined with an identical lesion of lymph nodes or skin.
According to statistical reports, this disease is most common among people in Northern Europe, as well as in African Americans and Asians. Mostly women are sick before the age of 40.To date, the etiology of the disease is not fully understood. The main reasons doctors consider heredity, infection, pathology of the immune system.
Classification of
Sarcoidosis of the lung exists in several forms, which simultaneously determine the stage of the disease as well:
- 1) Intramuscular initial lymphoblast form( 1st stage of the disease)
- 2) Mediastinal pulmonary form( 2nd stage of the disease)
- 3)Pulmonary( 3rd stage of the disease)
The mediastinal-pulmonary form is a lesion of the intrathoracic lymph nodes. This occurs along with the infiltration of lung tissue, as well as bilateral focal or miliary dissemination.
The pulmonary form represents the third stage of the disease. In this situation, the damage becomes more severe. Against the background of the formation of conglomerates, the appearance of pneumosclerosis and emphysema is documented.
Also, lung sarcoidosis is classified according to how fast it progresses.
In this case, isolated:
- chronic sarcoidosis
- delayed sarcoidosis
- progressive sarcoidosis
- abortive sarcoidosis
Symptoms of sarcoidosis of the lungs
Sarcoidosis of the lungs in most cases develops gradually. The first symptoms are felt by fever, joint aches, and sleep disturbances. A person feels constant fatigue and a breakdown. There is a loss of appetite and, as a consequence, quite a significant weight loss.
The presence of signs of lung sarcoidosis also depends on the stage of development of the disease. So, for the mediastinal-pulmonary form, cough and shortness of breath are common, which are combined with pain in the sternum.
Also with this form can be observed lesions of the skin, parotid and salivary glands, lymph nodes. The intramammary form is characterized by pain in the chest area, the presence of wheezing and coughing. These symptoms are combined with a high body temperature. Also at this stage, the nodal erythema of the skin is often diagnosed.
With a pulmonary form, coughing and shortness of breath increases, sputum is added to them, sometimes with an admixture of blood. Also, the work of all organs and systems worsens, in particular, signs of cardiopulmonary insufficiency develop.
Diagnosis
Diagnosis of the disease is based on the clinical picture, as well as a detailed examination of the patient's anamnesis and its heredity. Then a general blood test is performed. In sarcoidosis there are some changes in it, namely: leukocytosis, high ESR, eosinophilia, lymphopenia.
Patients with suspected pulmonary sarcoidosis are advised to undergo a series of procedures. First of all, CT of lungs and MRI.These studies determine focal dissemination, increases in the area of lymph nodes. Also, it is not superfluous to perform bronchoscopy.
The most accurate diagnosis, confirming or disproving the presence of lung sarcoidosis, gives a histological analysis. It is carried out over a biopsy, which is withdrawn during bronchoscopy, transthorcal puncture or biopsy. In addition, high reliability is shown by the application of the so-called Kveim test. This assay involves the administration of a sarcoid antigen subcutaneously.
After about 3 weeks, the site of the injection is excised and a histological analysis is performed with the sample. With a positive result of the Kveim test, development of a standard sarcoid granuloma is noted.
It is not uncommon for cases where sarcoidosis of the lungs occurs absolutely without any symptoms. As a rule, in such a situation, the disease is diagnosed during a prophylactic X-ray study.
Treatment of sarcoidosis of the lungs
Given the long development of pulmonary sarcoidosis, the patient needs constant medical supervision for 6-8 months. The purpose of specific types of medication depends on the stage at which the disease occurs.
All patients on dispensary registration are divided into several groups:
- patients with active sarcoidosis
- patients diagnosed with
- for the first time patients with relapse or exacerbation of the disease
- patients in which the sarcoidosis is in the inactive phase( residual events are observed)
There are no specific drugs that fight sarcoidosis for today, unfortunately. This is because the etiology of the disease has not been established.
Prognosis for treatment of sarcoidosis
In most cases, sarcoidosis proceeds in good order. At the same time, many of its forms are characterized by the absence of any obvious symptoms and do not give a person great discomfort.
Approximately 30% of patients with sarcoidosis of the lungs go into a chronic stage. In this case it is necessary to regularly monitor the doctor and prevent possible respiratory failure, which is often formed in a similar course of the disease.
In a number of patients, recovery is possible after the first successful course of treatment. In others, the disease can reminisce throughout its life with numerous remissions.
The prognosis for sarcoidosis of the lungs is significantly improved if the disease was detected in the early stages, which is why it is recommended not to neglect the prophylactic radiology procedures.
Complications of sarcoidosis
In sarcoidosis, complications can occur that mostly affect the airways and the cardiovascular system. To such complications, in particular belongs to the syndrome of the pulmonary heart. In this condition, the walls of the heart thicken, its blood supply is disturbed. As a result, heart failure may develop.
Lung emphysema, broncho-obstructive syndrome is also a common complication of lung sarcoidosis. The process of fibrotic sarcoid granulomas in about 10% of cases can lead to interstitial pneumosclerosis. Sometimes, against the background of sarcoidosis, tuberculosis of the lungs may appear, or an infection may occur.
Prevention of sarcoidosis
Preventative measures in sarcoidosis include the implementation of healthy lifestyle rules. In order to prevent a possible occurrence of the disease, it is recommended to stop smoking.
Also it is necessary to limit to a minimum the use in food of products with a different sort of unnatural additives, to limit contact with harmful chemical substances.
There is a special risk for sarcoidosis in people with already diagnosed pathologies of the immune system. Such people should be the most attentive to their health and, with the slightest suspicion, go to a medical facility.
People who have already diagnosed sarcoidosis should also take care of their health in order to prevent a possible complication of the disease. One of the important rules for such patients is the restriction of calcium intake.
Since sarcoidosis causes pathological formation of stones in the bladder, food rich in calcium will only accelerate this process. For the same reason, it is worth limiting your stay in the sun: sunbathing contributes to the increased production of vitamin D, which, in turn, increases the content of calcium in the blood.