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Sarcoidosis full review 2014

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12 papers 25 to 100 followers
By Jason Mann No BS pulmonary critical care fellow
Dominique Valeyre, Jean-François Bernaudin, Florence Jeny, Boris Duchemann, Olivia Freynet, Carole Planès, Marianne Kambouchner, Hilario Nunes
Sarcoidosis is a systemic disease, with lung involvement in almost all cases. Abnormal chest radiography is usually a key step for considering diagnosis. Lung impact is investigated through imaging; pulmonary function; and, when required, 6-minute walk test, cardiopulmonary exercise testing, or right heart catheterization. There is usually a reduction of lung volumes, and forced vital capacity is the most accurate parameter to reflect the impact of pulmonary sarcoidosis with or without pulmonary infiltration at imaging...
December 2015: Clinics in Chest Medicine
Marjolein Drent, Bert Strookappe, Elske Hoitsma, Jolanda De Vries
Sarcoidosis is a multisystem disorder of unknown cause(s). Less specific disabling symptoms, including fatigue and physical impairments, may have a major influence on the daily activities and the social and professional lives of the patients, resulting in a reduced quality of life. A multidisciplinary approach focusing on somatic and psychosocial aspects is recommended. Patients self-perceived knowledge about the importance of exercise and lifestyle should be improved. Developing the most appropriate therapeutic approach for sarcoidosis requires careful consideration of the possible impact of fatigue, small fiber neuropathy related symptoms, pain, cognitive functioning, and coping strategies...
December 2015: Clinics in Chest Medicine
Robert P Baughman, Jan C Grutters
About half of patients with sarcoidosis will need systemic therapy for their disease. Oral glucocorticoids are the standard first-line treatment for sarcoidosis. With time, patients might develop substantial morbidity from long-term use of high doses of these drugs. We propose a step-wise approach to the management of pulmonary disease in sarcoidosis and provide details about how and when to use alternatives to glucocorticoids. The antimetabolites, such as methotrexate, azathioprine, leflunomide, and mycophenolate, are often used as alternatives to steroids...
October 2015: Lancet Respiratory Medicine
Adriane D M Vorselaars, Heleen A Crommelin, Vera H M Deneer, Bob Meek, Anke M E Claessen, Ruth G M Keijsers, Coline H M van Moorsel, Jan C Grutters
Inconclusive evidence for the efficacy of infliximab in sarcoidosis hinders the global use of this potentially beneficial drug. To study infliximab efficacy in a clinical setting, we performed a prospective open-label trial in patients refractory to conventional treatment. Patients (n=56) received eight infusions of 5 mg·kg(-1) infliximab. Pulmonary function, disease activity measured by (18)F-fluorodeoxyglucose (FDG) by positron emission tomography (PET) and quality of life were part of the clinical work-up...
July 2015: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Joachim Müller-Quernheim, Antje Prasse, David R Moller
No abstract text is available yet for this article.
June 2014: Seminars in Respiratory and Critical Care Medicine
Annyce S Mayer, Nabeel Hamzeh, Lisa A Maier
Chronic beryllium disease (CBD) is a granulomatous lung disease that may be pathologically and clinically indistinguishable from pulmonary sarcoidosis, except through use of immunologic testing, such as the beryllium lymphocyte proliferation test (BeLPT). Similar to sarcoidosis, the pulmonary manifestations of CBD are variable and overlap with other respiratory diseases. Definitive diagnosis of CBD is established by evidence of immune sensitization to beryllium and diagnostic bronchoscopy with bronchoalveolar lavage and transbronchial biopsy...
June 2014: Seminars in Respiratory and Critical Care Medicine
James W Verbsky, John M Routes
Common variable immunodeficiency (CVID) is a primary immunodeficiency that is characterized by hypogammaglobulinemia and poor/absent specific antibody production. Granulomatous and lymphocytic interstitial lung disease (GLILD) is an increasingly recognized complication of CVID, occurring in 10 to 20% of patients. GLILD is characterized by non-necrotizing granuloma, lymphocytic interstitial pneumonitis and follicular bronchiolitis-histological patterns that are typically present in the same biopsy. GLILD is a multisystem disease and is frequently accompanied by diffuse adenopathy, splenomegaly, and extrapulmonary granulomatous disease most commonly in the lymph nodes, spleen, liver, and gastrointestinal tract...
June 2014: Seminars in Respiratory and Critical Care Medicine
Dominique Valeyre, Jean-François Bernaudin, Yurdagul Uzunhan, Marianne Kambouchner, Pierre-Yves Brillet, Michael Soussan, Hilario Nunes
Sarcoidosis is a systemic disease of unknown cause characterized by the formation of immune granulomas which most often involve the lung and the lymphatic system. Sarcoidosis may encompass numerous different clinical presentations. Typical presentations often prompt a rapid diagnosis while in 25 to 50% of cases, diverse and less typical presentations may lead to delayed diagnosis. The mediastinopulmonary sphere is involved in 85 to 95% of cases, associated with extrapulmonary localizations in half of cases while extrapulmonary localizations without lung involvement may be seen in 5 to 15% of cases...
June 2014: Seminars in Respiratory and Critical Care Medicine
Human Adams, Ruth G Keijsers, Ingrid H E Korenromp, Jan C Grutters
Fluorodeoxyglucose (FDG), labeled with a positron emitting fluorine-18 ((18)F), is a synthesized glucose analogue and is well known for its application in a wide variety of clinical conditions such as cancer. Visualizing metabolic activity of inflammation is another application of FDG in positron emission tomography (PET). Here, active granulomas appear to have a high affinity for FDG, which is reflected in a high sensitivity of FDG PET imaging. This has led to novel applications of FDG PET in sarcoidosis diagnosis and management...
June 2014: Seminars in Respiratory and Critical Care Medicine
Michael Y Shino, Joseph P Lynch Iii, Michael C Fishbein, Charles McGraw, Jared Oyama, John A Belperio, Rajan Saggar
Pulmonary hypertension (PH) is a significant complication of sarcoidosis, occurring in approximately 6 to > 20% of cases, and markedly increases mortality among these patients. The clinician should exercise a high index of suspicion for sarcoidosis-associated PH (SAPH) given the nonspecific symptomatology and the limitations of echocardiography in this patient population. The pathophysiology of PH in sarcoidosis is complex and multifactorial. Importantly, there are inherent differences in the pathogenesis of SAPH compared with idiopathic pulmonary arterial hypertension, making the optimal management of SAPH controversial...
June 2014: Seminars in Respiratory and Critical Care Medicine
Joseph P Lynch, Jennifer Hwang, Jason Bradfield, Michael Fishbein, Kalyanam Shivkumar, Roderick Tung
Clinically evident sarcoidosis involving the heart has been noted in at least 2 to 7% of patients with sarcoidosis, but occult involvement is much higher (> 20%). Cardiac sarcoidosis is often not recognized antemortem, as sudden death may be the presenting feature. Cardiac involvement may occur at any point during the course of sarcoidosis and may occur in the absence of pulmonary or systemic involvement. Sarcoidosis can involve any part of the heart, with protean manifestations. Prognosis of cardiac sarcoidosis is related to extent and site(s) of involvement...
June 2014: Seminars in Respiratory and Critical Care Medicine
Robert P Baughman, Elyse E Lower
For treatment of sarcoidosis, one should develop a long-term management plan. Factors to be considered include the organ involvement and severity of symptoms. Different organ manifestations may require different treatments. Intensity of treatment is usually based on severity of disease or potential for organ failure or death. Glucocorticoids are quite effective as initial therapy for most forms of sarcoidosis. However, the toxicity associated with long-term treatment often leads to the use of alternative treatments...
June 2014: Seminars in Respiratory and Critical Care Medicine
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