Sarcoidosis of lymph nodes is very common. As a rule, affects intrathoracic lymph nodes Lymph nodes - what keeps our immune system   (VGLU) and then joined to the primary manifestations of pulmonary sarcoidosis Sarcoidosis of the lungs - the most common form of the disease . Much rarer defeat external peripheral lymph nodes unchanged from other organs and tissues.

Sarcoidosis intrathoracic lymph nodes - that occurs in the body

The disease begins with increasing VGLU without radiographic changes in the lungs. But very often sarcoidosis Sarcoidosis - how to protect themselves?   VGLU combined with the development of characteristic granulomatous changes in other organs (skin, eyes, and so on). At the same time may increase the external lymph nodes (cervical, axillary, inguinal and elbow).

In the lymph nodes at the same time forms a characteristic inflammatory nodules - granulomas. If the center of granulomas located in other organs (including the lungs), usually no necrosis of the lymph nodes is a characteristic. The presence of necrosis in sarcoidosis is accompanied by fever, joint pain and other common symptoms of the disease. Necrosis demonstrates the high activity of the process.

If time does not suppress the disease process, it is likely there will be characteristic changes of sarcoidosis in the lungs.

Symptoms of the disease

Most often sakroidoz VGLU goes unnoticed and is a random finding in the X-ray examination for another reason. It occurs within and oligosymptomatic, which manifests itself in the form of increased fatigue, weakness. In sarcoidosis lymph nodes can meet different kinds of fatigue:

• fatigue arising in the morning, immediately after waking up - the patient stands up or not enough sleep;
• transient fatigue, when the patient wakes up quite cheerful, but after a while feels tired; little rest recovers his strength, such rest can be for a few days;
• Fatigue, which appears in the evening; by the end of the day the patient feels dead tired up until not go to bed;
• Chronic Fatigue Syndrome Chronic fatigue - if life is not a pleasant experience That develops after suffering sarcoidosis; Fatigue is often combined with depression.

Much less is acute sarcoidosis of lymph nodes from the start. The disease in this case begins with the appearance of fever, chills, headache, discomfort in the chest. Pain and discomfort in the chest occur frequently, the cause of their occurrence is not always possible to explain, as they have no direct connection to the nature and amount of changes in the lymph nodes. Often, there are unpleasant sensations and pain in the back, burning in the interscapular region, heaviness in the chest. Furthermore, there may be pain joints and muscles.

With increasing VGLU they can compress the bronchi which causes inflammation of the walls and the appearance of dry cough.

It has been observed that the presence of such symptoms of sarcoidosis lasts a long time and often gives relapses.

Diagnosis of sarcoidosis of lymph nodes

Symptoms of sarcoidosis lymph node similar to the manifestations of other diseases - tuberculosis, and other limfogranulomatoz. Therefore, even if accidentally enlarged lymph nodes without a patient of any complaint carried out a full examination.

First of all, carried out a general analysis of blood and urine tests, biochemical studies of liver and kidney function. To eliminate tuberculosis do Mantoux test - in sarcoidosis, in most cases it is negative.

The main importance is the X-ray examination. On the X-ray of the chest shows the increase in the amount of VGLU - bronchopulmonary, tracheobronchial, paratracheal, bifurcation. All changes in the lymph nodes are bilateral, symmetrical. One third of the patients in the lymph nodes may be areas of calcification, which is due to tuberculosis in the past transferred. To confirm the diagnosis carried out a computer or magnetic resonance imaging.

In some cases, further diagnosis biopsy Send the Prince - the contents of lymph node sampling for laboratory testing.

Treatment

If the disease goes unnoticed and does not progress, in some cases, after it was discovered the sick just watching for six months - are often signs of the disease spontaneously, without treatment. If the background of the enlarged lymph nodes characteristic VGLU appear, the treatment is prescribed in the form of courses glucocorticosteroid agents - corticosteroids (prednisone, dexamethasone, and others). Sometimes corticosteroids alternate appointment inflammatory drugs - NSAIDs (Naiza, diclofenac and others).

Sarcoidosis lymph nodes usually respond well to treatment, but then the patient should be screened regularly for recurrence of the disease elimination.

Galina Romanenko

Pulmonary embolism - a potentially fatal disorder, and is one of the possible diagnoses that must be considered when examining patients who complain of pain in the heart Pain in the heart - always consult a doctor . The classic symptoms of this condition - heart pain with a deep breath, shortness of breath and coughing up phlegm with blood. However, most patients with pulmonary embolism less severe symptoms, which often leads to errors in diagnosis.

Risk factors for the development of pulmonary embolism

• Prolonged restriction of physical activity, such as many hours traveling by plane or car;
• Recently undergone surgical operation or fracture;
• Hormonal contraceptives (for female smokers the risk is particularly high;
• Cancer;
• Pregnancy.

Pulmonary embolism begins to blood clots in the veins of the various parts of the body, most often - in the legs, at least - in the hands, the pelvis and the large veins of the abdominal cavity. Any blood clot sooner or later start to move in the veins, moving toward the heart. Such a clot is called an embolus, or trobmoembol. Over time, it may get into the circulatory system of the lungs, and to block one of the branches of the pulmonary artery, blocking thereby blood flow to the lung. As a result, blood flow from the lungs get enough of oxygen and the patient begins to suffer from shortness of breath, and ordinary physical activity are it harder than before. Often, there are pains in the chest, which is often considered the heart of pain, although in reality a slight pain, the operation of which is partially broken.

Some patients develop pulmonary embolism is accompanied by anxiety Anxiety - how to distinguish normal from disease?   and sweating. If the clot is very large, and immediately restricts the flow of blood to the vast area of ​​the lung, the first symptoms of a pulmonary embolism may be fainting or shock, in which the patient's blood pressure drops sharply and changing level of consciousness. Therefore, the condition of patients in pulmonary embolism can range from very severe to almost normal.

Diagnostics

Regular medical examination is not to diagnose pulmonary embolism; this requires special diagnostic procedures which are designated as a rule, on the basis of patient history.

Test D-dimers - it blood Blood tests: a mirror of health That in many cases helps to diagnose disorders associated with the formation of blood clots. If the test results are negative, the diagnosis of "pulmonary embolism" can be excluded, especially if the patient is not at high risk of developing this disorder. If the results are positive, it would require additional diagnostic procedures. For example, cancer patients and pregnant women test D-dimers often give positive results even in the absence of clots.

Often used to diagnose lung medical imaging, such as computed tomography, with which you can see clots in the pulmonary artery. If for technical reasons this is not possible, the expert may conduct ultrasound of veins in the legs; if the patient has symptoms of pulmonary embolism, and the legs are detected thrombi or fragments thereof, the diagnosis can be confirmed. However, if only the clot broke completely, ultrasound feet may not give results, even if the patient really developed pulmonary embolism.

Sometimes the diagnosis of pulmonary embolism is used angiography of the pulmonary arteries, but the equipment for this procedure have not in each hospital.

For the treatment of pulmonary embolism appointed anticoagulants. First, the patient receives or enoxaparin, heparin, and then, as a rule, for a long time - warfarin Warfarin - indirect anticoagulants . In typical cases, the total duration of treatment ranged from three to six months.

In more severe cases, the patient may need to thrombolytic therapy, along with the use of intravenous fluids and administration of drugs, normalizing blood pressure.