Pathology: Inflammatorydisorder with accumulation of T-cells and granulomas that can affect manysystems, most commonly the pulmonary system
Aetiology: Idiopathic.Most commonly affects younger adults (30-40 years), female> male
Symptoms: Upto 40% may be asymptomatic, dry cough, increasing dyspnoea, rash, neuropathy
Signs: Erythemanodosum and bilateral hilar lymphadenopathy, fine inspiratory crackles,uveitis, hypercalcaemia, polyarthralgia.
Investigations: Chest X-Ray: Bilateral hilarlymphadenopathy (90%), infiltrates
Bloods: ↑serum ACE, ↑ESR, ↑Ca2+
Spirometry: reduced lung volumes and/or a restrictivedefect.
Biopsy: Non-caseating granulomata
Treatment: Mayresolve spontaneously
Ifsymptoms persist then treatment with 6-12 months of oral steroids(prednisolone)
Complications: Canprogress to lung fibrosis, respiratory failure, cor-pulmonale
Prognosis: 60%recover in <2 years. Monitor with Chest X-rays, lung function and clinicalreview
BilateralHilar Lymphadenopathy
Figure 2.10 ChestX-ray demonstrating bilateral hilar lymphadenopathy
