Tuesday, October 28, 2008

SARCOID IN THE NEWS - Sarcoidosis hits in midlife, has long-lasting effects

You know It's great this is in the news as often as it is. I'm actually quite surprised at how many recent articles I have been finding. This is is from my hometown newspaper, The Star Ledger, Newark, NJ edition. I believe it's from a doctor in Hackensack University Medical Center. A Dr. R. Knight Steel. It's the only name on the article so I guess it's his.

Sarcoidosis hits in midlife, has long-lasting effects
Tuesday, October 28, 2008
MANY CHRONIC CONDITIONS begin in midlife or shortly before, and impact an individual's well being to a varying degree for half a century. One such condition is sarcoidosis, which often makes its initial appearance around age 40.

A person with this condition may experience a single chronic symptom, often shortness of breath, which compels that individual to seek medical attention. Other people become aware of enlarged nodes, often mildly tender, in the neck or under the arms. Still others discover little red bumps often on the shins or red spots frequently on the face. Difficulty with vision, an irregular heart beat, painful joints, an enlargement of the salivary glands under the cheeks, abdominal pain or just a sense of fatigue also may be occur.

An individual may experience different symptoms at different times in life. The symptoms may even be so mild that the person does not seek out medical attention and is not even aware of the fact that he has the disease.

Most people with sarcoidosis have an abnormal chest X-ray. Quite often, the serum level of calcium is elevated and there may be an abnormality of one of the tests of liver function. Because the lung often is the major site of involvement, a lung biopsy or a lung washing by means of a bronchoscopic examination may be needed to make the diagnosis. At other times, a biopsy of a lymph node or another organ may be utilized to confirm the diagnosis.

Although the cause of this disease is unknown, there is evidence that an abnormal immunological response to some allergen is responsible. This produces little lumps, known as granulomas, that initially are visible only under the microscope, but which may become large enough at a later time to be felt or seen.

A corticosteroid, prednisone, is the usual treatment. It often is prescribed intermittently and in varying dosages. Elders who have had sarcoidosis for years or decades may experience a flare-up in one or more organs, especially the lungs, that requires treatment with this drug. Other drugs may be used especially if the individual has significant side effects from the prednisone or the disease is particularly active.

Sometimes, an entirely new symptom will make its appearance late in life, reflecting the involvement of a different organ with sarcoidosis. For example, some elders may have an acute visual problem that requires an assessment by an ophthalmologist and treatment targeted to disease in the eyes. Other elders with this condition may need urgent attention because the disease has involved the central or peripheral nervous system.

Elders who have one or more chronic diseases always should notify every medical specialist visited for any reason about these conditions. Especially when the chronic condition, such as sarcoidosis, has so many very different symptoms, every physician will want to consider it when trying to diagnose and treat a new medical problem.

Write to Dr. R. Knight Steel at Hackensack University Medical Center, 30 Prospect Ave., Hackensack, N.J. 07601.

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