Sarcoidosis, pathophysiology clinical aspects and management
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- čas přidán 3. 02. 2018
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Sarcoidosis is discussed as part of restrictive lung diseases. We will discuss:
The connection of Sarcoidosis with the respiratory system.
Definition:
A non-caseating granulomatous disease of unknown etiology involving multiple systems.
Guidelines for the diagnosis:
TB, Fungi, Viruses, and other agents (Borrelia) can cause non-caseating granulomas.
Demography:
Genetics, immune disorders (CD4 cell dysregulation), HLA-B1, HLA-B8, African Americans, women more than men, young patients, non-smokers.
Pathogenesis:
Mechanism of production of non-caseating granuloma.
Antigen's arrival.
Antigen presenting cells' (APCs) response.
CD4 cells in the lymph nodes (hilar and paratracheal) get involved.
IL2 release.
The monoclonal proliferation of the CD4 cells.
IL4-IL5 release leading to polyclonal B cell proliferation in the lymph nodes.
IFN-gamma release.
Activation of macrophages.
The release of IL8, TNF, MIP-1alpha.
Epithelioid cell formation.
Multinucleated giant cell formation.
Granuloma formation.
A ring of CD4 cells around the granuloma.
Concentric deposition of Ca++ and proteins inside the cells. Schaumann bodies.
Asteroid body formation.
Organs involved.
Skin lesions on the scalp, nose, cheeks, and the lips. Even on the back and neck.
Lupus Pernio.
Painful lesions (erythema nodosum) on the front of the legs.
Pituitary gland involvement. Resulting in diabetes inspidus.
Meningitis.
Parotid gland involvement leading to xerostomia.
Eye involvement
Lacrimal gland inflammation - sicca syndrome.
Pericarditis of the heart.
Hilar lymphadenopathy.
Paratracheal lymphadenopathy.
Liver and spleen enlargement due to granulomas in the liver.
Clinical aspects:
In some patients, ACE enzyme increases.
Alpha-1 hydroxylase is increased which in turn causes hypercalcemia.
Hypercalcemia occurs.
10-15% of patients will develop progressive interstitial fibrosis with poor prognosis.
Usually resolves automatically.
Steroid can be given.
TNF blockers can also slow down this disease. ...
Disclaimer:
This video is not intended to provide assessment, diagnosis, treatment, or medical advice; it also does not constitute provision of healthcare services. The content provided in this video is for informational and educational purposes only.
Please consult with a physician or healthcare professional regarding any medical or mental health related diagnosis or treatment. No information in this video should ever be considered as a substitute for advice from a healthcare professional. ...
Disclaimer:
This video is not intended to provide assessment, diagnosis, treatment, or medical advice; it also does not constitute provision of healthcare services. The content provided in this video is for informational and educational purposes only.
Please consult with a physician or healthcare professional regarding any medical or mental health related diagnosis or treatment. No information in this video should ever be considered as a substitute for advice from a healthcare professional.
I was diagnosed with Sarcoidosis last year and have been living with it since. This video is very informative and greatly appreciated. I think I've had it much longer than a year and had no symptoms that presented until last year. This video has allowed me to connect the dots and better understand why my body is reacting the way it is. Thank you very much!
Absolutely one of the best tutors of medicine on CZcams. Thank you SO much for these great videos!! Hats off to you from Korea..
As a sarc patient, I found this lecture to be very informative. Mine was discovered in 2015, during a right lung lobectomy for a carcinoid tumor. So far, sarcoidosis is still active.
i just was diagnosed with sarc two weeks a go but I think I have this disease many years I been in the hospital with bronchitis like 6 time in the last 2 years and i have pneumonia three weeks a go the doctor put me on steriods and inhale therapy y just star to do my research anytime for me to learn how to fight this disease I will grateful . Thank you ...
What an amazing disease ..
Sir your way of explanation makes it too easy to understand 💓💓
Thank you for this excellent presentation!
Thx sir! As a doctor I found dis lecture very good n informative
I am a sacr patient with lymph and bronc , very lucky lung s stayed bright pink and healthy.Non-smoker, had it since 1997 and hard breathing after stressing body. Thank you for posting. I always s try to learn as much as I can , it really helps!
Lyle Raustadt hi.. can u answer what were ur symptoms and how did u got diagnosed? hope u are fine..
Thank you Dr.Mobeen. Great video.🙂
3rd and 4th stage lung infiltrates w my sarcoid diagnosis. Great vid
Hello I am 50 years old and I work a midnight shift at a hotel/restaurant delivering room service. I acquired sarcoidosis from accidentally inhaling an insecticide that is used by the Orkin Bug exterminator company. I did some research and they also gave me the chem sheets of the ingredients of the spray. The one main ingredient was a chemical made from a tree nut from another country. The side effects were that of breathing problems and to seek fresh air if inhaled. Just thought I would pass this info on to you for future research. Maybe some of the sarcoidosis sufferers like myself are allergic to this chemical used in hotels /restaurants by Orkin. Thank you
Thanks you sir for understable explanation.
Dr your amazing, same happens with me since six months so far ...
Excellent lecture!!!! Very explanatory, very simply presented knowledge!! Great sketches!!!
Thank you, dear. Have you checked drbeen.com for more lectures?
Thank you for this video. I feel as if I FINALLY understand this diagnosis I’ve been handed and had no idea what to do with.
Sorry to hear that. Glad that the lecture helped with the understanding.
Frances Mechelle sarcoidosis warrior I understand hope you take care be well
Frances Mechelle that is exactly how I feel, I got my diagnosis last week. This video answered a lot of questions for me as well.
Thank you very much sir...your explanation method is really fantastic...
Thank you very much you saved me!!!
thank uuu so muchhhhh ........your videos are just amazing
TB and fungi both caseating granuloma
thanks for the video ..🙏🙏
You are so cute! ''The ninja antigen.'' This is very helpful and well done! Thank you!!
respect from india !
Very interesting thank you
Thank you soo much for your deep insights and generous details.
May I point out that I have been able to avert a progression (uveitis, lung, pericarditis) by an absolute diet restriction of both gluten and dairy products. (Nurse training and pubmed reading) I am yet to find out what impact if any- a tick bite had on all these.
I am impaired by isolation in Perth, Australia .
Cheers
Thank you. That was very informative!
Very well explained. Thank you.
You are very welcome!
Is there anyway to reverse or lessen the granulomas from forming?
Awesome sir👌
Many thanks from the middle east 👌❤
You are very welcome ❤️
TB causes caseating granuloma right? how tb is a differential diagnosis of sarcoidosis? can someone explain?
Thank you so much
sr plz explain the endocrinology too plz sir ... thanks 😊
THANKS ALOT SIR !
thank you sir plz upload pneumonia
Thank you sir
Could EBV be related?
Thank you 🙂
Wonderful
Thank you 🤩
شكرا🌸🌸
You are most welcome.
Tb cause caseating granuloma not noncaseating granuloma
Tuberculosis mostly has casseating but non casseating can also be found.
Tuberculosis causes casseating granuloma but can also cause non casseating granulomas
Nice lecture sir
Thank you
Cell most frequently found in granuloma? 1) lymphocytes 2)giant cells
thanks
Tuberculosis is typical of caseous granuloma rite??
Ritu Ritu yes tb is the most common presentation of this type of necrosis
Yaa
Yes
All infection like Tb histoplasmosis nd coxicoid mycosis are caseating granuloma
Thank you
If i subscribe then is there the pathologies of all systems available that is more than that available on youtube ? How many videos of pathology will be available if i subscribe ?
Plz answer dr been
Dear Vishali, much more videos than here. Go to DrBeen.com and click on the video library. You can check the list of lectures there.
Great thanks from Russia!!!
Thank you. Welcome from the US 😀
Granuloma load proportional to hypercalcemia
❤
As a sarc patient, I found this lecture to be very informative. Mine was discovered in 2015, during a right lung lobectomy for a carcinoid tumor. So far, sarcoidosis is still active.