Sarcoidosis of the lungs is an ailment that people who are far from medicine are often confused with tuberculosis, which also affects this organ. However, being a benign systemic disease, sarcoidosis is not so dangerous. In medical practice, cases of independent resolution of this disease are not uncommon, not associated with any treatment.
Sarcoidosis most often affects patients of the age category from twenty to forty years, and women suffer more often than men. Cases of diseases among children and elderly patients are single.
It is interesting that the prevalence of lung sarcoidosis has both geographical and racial characteristics. African Americans, Puerto Ricans, Hindus and Australians are most susceptible to this disease.
Among the European population, Germans, Scandinavians and Irish suffer the most from sarcoidosis. The incidence among Japanese is extremely low. In Russia, sarcoidosis of the lung is detected in five people out of a hundred thousand people.
What is this disease?
Sarcoidosis of the lungs in medical literature can be referred to as Beck sarcoidosis or Bénie-Beck-Schauman disease.
Externally similar to tuberculosis granulomas, multiple sarcoid nodules formed by the accumulation of giant and epithelioid cells do not, however, lead to the development of caseous necrosis and do not contain pathogens of tuberculosis. The constant growth of sarcoid granules results in their fusion and the formation of multiple large and small foci.
Photo of the lungs in sarcoidosis
It is the presence of these foci that causes disruption of the affected organs and the appearance of characteristic symptoms of sarcoidosis. At the end of the disease, there is either a resorption of sarcoid nodules, or fibrous changes in the tissues of the affected organs.
Causes of development of
The etiology of Beck's sarcoidosis is still unclear.
- Supporters of infectious genesis believe that the disease can develop through the pathogens of pathogens( fungi, spirochetes, mycobacteria, protozoa, etc.).
- Acknowledgment of the genetic nature is the research based on the study of family cases of sarcoidosis.
- A number of specialists see a link between the development of the disease and the inadequate response of the human immune system to the effects of endogenous and exogenous factors.
Most authoritative researchers are inclined to consider it a polyethological disease, the emergence of which is due to several causes( genetic, immune, morphological, biochemical nature).
Specialists drew attention to the correlation of morbidity with the professional activity of patients.
Sarcoidosis often affects workers in agricultural and chemical industries, doctors, seamen, postal workers, millers, mechanics and firefighters: people exposed to toxic substances and infections. The risk of developing the disease and smokers is also great.
Symptoms of
- Signs of the initial stage of pulmonary sarcoidosis are characterized by a number of nonspecific manifestations. The patient is characterized by severe malaise, anxiety, fatigue, weakness, lack of appetite, a sharp decrease in weight, fever, bouts of night sweats, significant sleep disorders.
- Sarcoidosis of the lungs, entering the first stage, manifests itself ambiguously: in some patients it is asymptomatic, while others experience extreme weakness, pain in the joints and in the chest, they have fever, a cough, and erythema nodosum develops.
- In the second stage of the ailment of patients, dyspnea, cough, severe chest pains are excruciating. When listening to( auscultation) of the lungs, the specialist notes the presence of dry and wet wheezing and crepitations( characteristic noise resembling the sound that emits hair rubbed by the fingers near the ear).The patient has a number of extrapulmonary manifestations of the disease: his eyes, skin, bones, parotid glands, peripheral lymph nodes are affected.
- Pulmonary form is accompanied by severe shortness of breath, pain in the chest, cough with sputum, joint pain( arthralgia).Even more complicating the condition of patients is the attachment of such ailments as emphysema, cardiopulmonary insufficiency and lung sclerosis.
Forms and stages of
X-ray data allow us to identify three stages and the same number of corresponding forms in the clinical course of sarcoidosis of the lungs.
- The first stage of and the corresponding initial intrathoracic lymphoid-ferruginous form of the disease is characterized by a bilateral( usually asymmetric) increase in the intrathoracic lymph nodes.
- In the second stage of , which corresponds to the mediastinal-pulmonary form of sarcoidosis, pathological changes occur in the tissues of the middle and lower parts of the lungs with the formation of foci and the lesion of the intrathoracic lymph nodes.
- The third stage of and the pulmonary form of sarcoidosis are characterized by pronounced pulmonary fibrosis, the formation of drainage foci( conglomerates), followed by the development of emphysema and lung sclerosis.
What is dangerous?
Without skilled treatment, advanced sarcoidosis of the lungs can adversely affect the functioning of the kidneys, liver, heart, brain.
The most serious consequences of lung sarcoidosis include development:
- emphysema;
- of pulmonary heart syndrome;
- respiratory failure;
- complete blindness( with too late diagnosis);
- a number of nonspecific lung diseases.
The process of fibrotic sarcoid granulomas in a tenth of patients ends with lung sclerosis, and in some cases leads to the formation of a cellular( "cellular") lung. Often in patients with sarcoidosis, aspergillosis and tuberculosis develop.
Sarcoid granulomas that have affected the parathyroid glands can lead to the development of hyperparathyroidism - a serious pathology of the endocrine system. The accompanying violation of calcium metabolism can result in a fatal outcome for the patient.
They can not get infected either by physical contact with the patient or through household items. As for personal hygiene items, they must be individual for each member of the family, regardless of the health status of each of them.
Diagnosis
Given the similarity of the symptoms of pulmonary sarcoidosis with a number of other diseases( tuberculosis, lung cancer, systemic lupus erythematosus, rheumatoid arthritis, lymphoma) and the associated possibility of diagnostic errors, the patient is prescribed:
- General blood test. In sarcoidosis, he reveals the presence of leukocytosis, increased level of eosinophils, accelerated ESR.
- Mantoux test. Being negative, it will indicate the absence of tuberculosis in the patient.
- X-ray examination of the chest organs demonstrates the presence of granulomatous foci and cirrhosis in the lung tissue, a significant increase in lymph nodes and emphysema.
- Magnetic resonance imaging and computed tomography( MRI) are needed to detect granulomas in the lymph nodes, lungs, internal organs, and the brain.
Photo of a CT scan of diagnosis in sarcoidosis of the lung
- Intracutaneous introduction of a sarcoid antigen reveals in 50% of patients the presence of a positive Kveim reaction, manifested in the appearance of a dark red nodule.
- The bronchoscopy procedure combined with taking a biopsy reveals the presence of enlarged vessels at the base of the bronchi, enlarged lymph nodes, atrophic bronchitis, sarcoid lesions of bronchial mucous membranes covered with tubercles, plaques and warty growths.
- The most objective diagnostic method is the histology of the biopsy specimen taken by bronchoscopy, pre-stained biopsy, pulmonary biopsy, mediastinoscopy and transthoracic puncture. In sarcoidosis, all specimens of the biopsy specimen should contain elements of sarcoid granules with no signs of necrosis and inflammation in the circumference of the focus
Degree of sarcoidosis of the lungs and their treatment
The degree of sarcoidosis of the lungs is isolated on the basis of an X-ray study:
- At zero degree of manifestation of sarcoidosis there are no.
- 1 degree reveals the presence of a bilateral increase in intrathoracic lymph nodes( bilateral lymphadenopathy).
- At 2 degrees to bilateral breast lymphadenopathy, pulmonary infiltrates( compacted areas of lung tissue with accumulation of non-characteristic cells) are attached.
- grade 3 is characterized by the presence of infiltrates in the lung parenchyma without an increase in the intrathoracic lymph nodes.
- At 4th degree, the lung parenchyma loses its volume as a result of pulmonary fibrosis, calcification processes, the formation of multiple cysts and emphysema.
Features of treatment depending on the degree of the disease:
- Clinical manifestations of the first degree of sarcoidosis may be absent altogether or may be known by the presence of severe sweating, weakness and fever. At this stage, drug therapy is not prescribed.
- The second degree is characterized by the symptoms of lung damage: shortness of breath, coughing, sometimes with hemoptysis. That is why sarcoidosis of this period is mistaken for lung cancer or tuberculosis. Listening to the lungs reveals the presence of dry and wet wheezing. At the end of sarcoidosis of the second degree in some patients granulomatous foci can completely resolve, and pulmonary tissues - restore its normal structure;others have a fibrous nucleus in place of the granule. For the treatment of second-degree sarcoidosis, hormone therapy with prednisolone is recommended.
- With sarcoidosis of the lungs of the third and fourth degree, there is an increase in the symptoms of fibrosis, respiratory failure and the development of emphysema. The main therapy consists in the treatment of corticosteroids( most often prednisolone).To exclude the possibility of relapses, corticosteroid therapy is carried out for several years.
How to defeat sarcoidosis of the lungs, will tell the following videos:
In addition, the patient is prescribed the use of immunosuppressants( azathioprine, delalgil, resochin), antioxidants( tocopherol and retinol), anti-inflammatory drugs( aspirin, indomethacin).If the doctor has chosen a combined treatment regimen, corticosteroids( dexamethasone, prednisolone, polcortolone) alternate with anti-inflammatory nonsteroidal drugs( voltaren or indomethacin).
Pulmonary fibrosis and a high risk of pulmonary hemorrhage threatening the patient's life are indications for surgery( up to transplantation of a healthy lung).
How to cure disease with folk remedies?
The initial stages of lung sarcoidosis are easily amenable to treatment with folk remedies. With neglected forms, they are used as an auxiliary therapy for drug treatment prescribed by a doctor.
Folk remedies for lung sarcoidosis:
- Excellent results are obtained by tincture, prepared from propolis( 20 g) and medical alcohol( 100 ml).The infusion time is seven days. The agent( 15-20 drops) is diluted with warm water( 200 ml) and taken in the morning, afternoon and evening. The signal to stop treatment is the emptying of the bottle.
- Very effective is a preparation made from sunflower oil and vodka, taken in 30 ml. It should be taken three times a day( at equal intervals between doses).The duration of the course is about a year.
- When sarcoidosis is useful once a day, rub a teaspoon of tincture from lilac flowers to the area of the affected lungs( both behind and in front).Filling a third of the glass with fresh lilac flowers, it is topped up with vodka and, after pouring the mixture into a bottle, is insisted for a week.
Dietary food
From the diet of patients with lung sarcoidosis completely exclude:
- products saturated with simple carbohydrates: sugar, baked goods, confectionery, sweet fizzy drinks;
- spicy, salty, spicy food( with the exception of garlic and onions: they are considered useful).
The use of dairy and fermented milk products( with the exception of butter) should be substantially limited. Dishes for the patients are steamed, stewed and boiled.
Eating a patient with sarcoidosis of the lungs should be:
- fractional( take food at least six times a day);
- balanced, containing a sufficient number of proteins( they are in eggs, lean meat and fish), vegetable fats( useful fatty fish), complex carbohydrates( it is necessary to eat vegetables, cereals, wholemeal bread), vitamins and microelements( fruits and vegetables are needed).
Extremely useful in sarcoidosis: cherry, black currant, pomegranates, sea-buckthorn, chokeberry, gooseberries, sea kale, peas, beans, nuts, apricot kernels. Recommended freshly squeezed juices: apple-carrot, pomegranate, orange.
Is it possible to heal patients?
Sarcoidosis of the lungs is curable. Moreover, in a third of patients this disease ends in a spontaneous resolution that does not require any medication.
Forecast
The course of sarcoidosis of the lungs is of good quality.
With a generalized( extremely rare condition) of lung sarcoidosis that has not been treated, a fatal outcome is likely.
Prevention
Given the unidentified etiology of the disease, methods for its specific prevention are still not available. Nonspecific preventive measures are reduced to reducing the impact of occupational hazards on the organism of people at risk, as well as strengthening their immune system.
Video conference on the causes and symptoms of lung sarcoidosis: