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Sarcoidosis
 Dr.CSBR.Prasad, M.D.,
Sarcoidosis
•   Sarcoidosis is a multisystemic disease
•   Unknown cause
•   Characterized by noncaseating granulomas
•   Lymphanodes, Lung, Skin, Eye
•   Dx is made by exclusion
Other causes for non-caseating granulomas:

    •Fungal infections
    •Berylliosis
    •some mycobacterial infections
Sarcoidosis

•   More common in females
•   More common in blacks
•   Rare in Asians
•   Thought to be immunologically mediated
Sarcoidosis

It is a disease of disordered immune
 regulation in genetically predisposed
      individuals exposed to certain
          environmental agents
Sarcoidosis

1. Immunological factors
2. Genetic factors
3. Environmental factors
Sarcoidosis

           1. Immunological factors:
• Intra-alveolar and interstitial accumulation of CD4+ T
cells
• Increased levels of T cell–derived TH1 cytokines such
as IL-2 and IFN-γ
• Increased levels of several cytokines in the local
environment - IL-8, TNF
• Polyclonal hypergammaglobulinemia
Sarcoidosis

2 - Genetic Factors :

     • HLA-A1 &

     • HLA-B8
Sarcoidosis

     3 – Environmental Factors :

Several putative microbes have been proposed as
the inciting agent for sarcoidosis

  1. Mycobacteria
  2. Propionibacterium acnes, and
  3. Rickettsia species
Sarcoidosis
  Morphology: Virtually every organ in
   the body may be involved in this
   disease

well-formed non-caseating granulomas

Schaumann bodies

Asteroid bodies
Noncaseating granulomas
Noncaseating granulomas
Asteroid bodies
Asteroid body
Schaumann bodies
Sarcoidosis
• Lungs – Pleural involvement is rare
• Lymph nodes – Egg shell calcification
                     Mediastinal LNs
• Skin lesions – Discreet subcutaneous
  nodules
• Eye – Iritis, iridocyclitis
• Parotids may be involved
• Muscle weakness and tenderness
Sarcoidosis

If you are encountered with a patient
   with multisystemic manifestaions
  have sarcoidosis in your diferential
E N D

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Sarcoidosis

  • 2. Sarcoidosis • Sarcoidosis is a multisystemic disease • Unknown cause • Characterized by noncaseating granulomas • Lymphanodes, Lung, Skin, Eye • Dx is made by exclusion Other causes for non-caseating granulomas: •Fungal infections •Berylliosis •some mycobacterial infections
  • 3. Sarcoidosis • More common in females • More common in blacks • Rare in Asians • Thought to be immunologically mediated
  • 4. Sarcoidosis It is a disease of disordered immune regulation in genetically predisposed individuals exposed to certain environmental agents
  • 5. Sarcoidosis 1. Immunological factors 2. Genetic factors 3. Environmental factors
  • 6. Sarcoidosis 1. Immunological factors: • Intra-alveolar and interstitial accumulation of CD4+ T cells • Increased levels of T cell–derived TH1 cytokines such as IL-2 and IFN-γ • Increased levels of several cytokines in the local environment - IL-8, TNF • Polyclonal hypergammaglobulinemia
  • 7. Sarcoidosis 2 - Genetic Factors : • HLA-A1 & • HLA-B8
  • 8. Sarcoidosis 3 – Environmental Factors : Several putative microbes have been proposed as the inciting agent for sarcoidosis 1. Mycobacteria 2. Propionibacterium acnes, and 3. Rickettsia species
  • 9. Sarcoidosis Morphology: Virtually every organ in the body may be involved in this disease well-formed non-caseating granulomas Schaumann bodies Asteroid bodies
  • 15. Sarcoidosis • Lungs – Pleural involvement is rare • Lymph nodes – Egg shell calcification Mediastinal LNs • Skin lesions – Discreet subcutaneous nodules • Eye – Iritis, iridocyclitis • Parotids may be involved • Muscle weakness and tenderness
  • 16. Sarcoidosis If you are encountered with a patient with multisystemic manifestaions have sarcoidosis in your diferential
  • 17. E N D