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



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BilateralHilar Lymphadenopathy


Figure 2.10 ChestX-ray demonstrating bilateral hilar lymphadenopathy


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