- Sarcoidosis of the lungs - the most common form of the disease
- Symptoms
- Diagnosis and treatment
Sarcoidosis of the lungs - is the most common form of sarcoidosis. Why is this disease begins is unknown. Most new cases are young women. It is thought that multiple causes sarcoidosis. It has the value of heredity, state immunity, the various effects of the environment and so on.
What is pulmonary sarcoidosis
Sarcoidosis - a systemic disease in which organs and tissues appear small inflammatory nodules - granulomas. Sarcoidosis of the lungs - a form of the disease, it can be an independent, and can be combined with other manifestations of systemic sarcoidosis. Despite the similar name, sarcoidosis has no relation to the cancer sarcoma. The term "sarcoidosis" appeared in the late 19th century because of the resemblance of skin changes with sarcoma.
Respiratory sarcoidosis occurs in the vast majority of patients with this systemic disease. This affects the lungs and nearby lymph nodes
Lymph nodes - what keeps our immune system
(bronchopulmonary, tracheobronchial, intraperitoneal). It is often combined with pulmonary sarcoidosis is similar changes in other organs and systems. May be affected skin, nervous system, organs of vision, liver, spleen, kidneys, heart, bones and joints.
Sarcoidosis of the lungs often goes unnoticed and is detected only when the violation of the respiratory function. They suffer more often young women up to 40 years.
The disease is almost common in children and the elderly. An interesting fact is that sarcoidosis rarely occurs in smokers. But if the disease has already begun, smoking can greatly complicate its course.
A feature of sarcoidosis is the formation of multiple granulomas of epithelioid and giant cells. When resemblance to tuberculous granulomas, nodules of sarcoidosis is not characterized by the development of caseous necrosis and the presence of Mycobacterium tuberculosis. As the sarcoid granulomas coalesce into multiple small and large pockets. The foci of granulomatous lung concentrations violate its function and lead to the emergence of symptoms of sarcoidosis. The outcome of sarcoidosis is the resorption of granulomas or fibrosis of the affected organ.
Sarcoidosis of the lungs - Causes
Until a few decades ago, it has been suggested that sarcoidosis - a form of TB caused by, attenuated mycobacteria. Today, it is well established that tuberculosis
Tuberculosis - a full recovery is not guaranteed
and sarcoidosis - different diseases. Sarcoidosis - it is not an infectious disease, they can not be infected.
Nowadays, most researchers are of the opinion that sarcoidosis
Sarcoidosis - how to protect themselves?
- Polietiologic this disease, ie a disease caused by several factors. At the heart of it, most likely, it is a genetically modified organism reactivity - its response to different environmental impact. On the crucial role of heredity researchers brought the fact that there are familial cases of sarcoidosis.
In particular sarcoidosis lung disease may be the cause of the structural features of the respiratory and immune systems, combined with external factors such as permanent residence in a dusty environment, mine and so on. Nevertheless, the ultimate cause of the disease has not been established.
What happens in the lungs in sarcoidosis
The walls of the bronchi and lungs are formed small inflammatory nodules - granulomas. The granulomas can be of two types:
- The first type - stamped or sclerosing - small granulomas clearly demarcated from the surrounding tissue: they are surrounded by fibroblasts
Fibroblasts: the mystery of the connective tissue
- Connective tissue cells;
- The second type - large granulomas, often without clear boundaries.
Granuloma formation control stage cytokines - molecules information. The disease is based on the reaction of delayed-type hypersensitivity (DTH). During the activation of cytokines HRT vascular endothelium (inner shell wall of blood vessels). Thus the blood cells responsible for the inflammatory process (monocytes and lymphocytes), rush from the bloodstream and in tissues hearth HRT. There is also the activation by cytokines macrophage function (immune cells) located in the alveoli of the lungs, and tissue damage secretion products of activated macrophages. Stimulation of macrophages leads to the abnormal secretion of ACE (angiotensin converting enzyme which converts the inactive angiotensin I to the active angiotensin II and contributes to the blood pressure).
Simultaneously with granulomatous processes occur damage to the surrounding tissue granuloma - they violated the metabolic processes, and necrosis (dying) cells. If in the lungs and bronchi of the first type dominated granuloma, changes in the surrounding tissues is usually minor. But if the second type dominated granulomas in the lungs and bronchi develops considerable necrotic changes - lung tissue is disrupted and replaced by connective tissue. This leads to a decrease in respiratory function.
In rare cases, acute course of pulmonary sarcoidosis develop a serious defeat of the body with the development of granulomas in the lung tissue septa mezhalveolyarnyh and phenomena granulomatous vasculitis (inflammation of the walls of capillaries).
Granulomas in sarcoidosis is easily confused with tuberculous granulomas. Sometimes confirm the diagnosis of the disease can only laboratory study of biopsy material - pieces of tissue taken for analysis at the time of endoscopy.
Classification of pulmonary sarcoidosis
Widespread classification of sarcoidosis of the chest on chest X-ray. There are five stages of the disease:
- Stage 0 - changes on the chest radiograph is not;
- Stage I - hilar lymph nodes; changes in lung tissue not;
- Stage II - hilar lymph nodes; changes in lung tissue; pulmonary sarcoidosis 2 degree (stage) - the most characteristic manifestations of the disease;
- Stage III - the changes of the lung tissue without increasing the intrathoracic lymph nodes;
- Stage IV - the irreversible pulmonary fibrosis - replacement of lung tissue by connective tissue.
