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Lung sarcoidosis: forms, symptoms, and treatment

The disease is referred to as systemic lesions. Its second name is “Schaumann's disease — Benye Beck” or simply “Beck's disease.”

In sarcoidosis, specific granulomas form in the lung tissue, and the disease itself can occur with a variety of internal organs, but the bronchopulmonary system affects more than 90% of all cases of primary sarcoidosis.

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Lung sarcoidosis - what is it?

Lung sarcoidosis - what is it?

Lung sarcoidosis - what is it?

The basis of the disease is granulomatous inflammation, which is manifested by the formation of many nodules in the lungs. With a superficial glance, these granulomas can be mistaken for manifestations of pulmonary tuberculosis, and usually, at first patients suspect pulmonary tuberculosis in patients.

Sarcoidosis is a totally non-contagious disease.

Characteristically, sarcoidosis occurs at a young age, from 25 to 45 years old, and its prevalence in females is higher than in men. For nodules in sarcoidosis, they tend to merge, which leads to the formation of large foci, and often changes the x-ray picture of the disease.

Separate and rarely located nodules cause no symptoms, and such a latent course can only be detected by radiography of the lungs.

A sarcoid granuloma can spontaneously “dissolve”, but more often its outcome occurs in fibrosis, which is the replacement of the granuloma with scar tissue. It also disrupts the lungs.

In addition to damage to the lungs, sarcoidosis of the skin, liver, spleen and eyes is possible. In more rare cases, bones, joints, heart, kidneys and even the salivary glands are affected. Therefore, sarcoidosis can occur in any organ and tissue other than the teeth.

Causes

Causes Beck's disease has an unclear origin, as doctors say - "cryptogenic nature" and "unclear etiology." There is not a single firmly established reason for its development.

Many researchers are inclined to autoimmune theory, the influence of microbes and viruses. Some associate the occurrence of sarcoidosis with affection of the lung tissue in certain professions: pharmacists, chemical workers and other kinds of activity.

Forms and mechanism of development of sarcoidosis

The ambiguity of the causes led to the fact that the cause of the disease must be considered a complex of different factors that triggers the process of granulomatous inflammation.

The first symptoms of Beck's disease is the defeat of the respiratory acini with the development of alveolitis, as well as peribronchitis. Then hypoventilation develops, and the disease begins to manifest itself with an inherent clinical picture.

Lung sarcoidosis has several forms:

  • damage to the intrathoracic lymph nodes;
  • damage to the alveolar tissue - the lung proper sarcoidosis;
  • mixed form, which affects both the alveoli and lymph nodes;
  • generalized form in which, in addition to the bronchopulmonary system, other organs are also affected, for example, the skin or liver.

The most common are the first two forms of lesions of the bronchopulmonary system.

Stage of the disease

Stages of sarcoidosis

There are three stages of sarcoidosis of the lungs, which can be called "degrees".

Their names are quite conditional:

  1. In the first stage, only the lymph nodes are affected, and the lung tissue is not affected.
  2. Sarcoidosis 2 degrees of the lungs already, except for lymph nodes, affects the lung tissue. At this stage there may already be symptoms indicating the development of respiratory failure;
  3. The third stage is characterized by severe pneumosclerosis or pneumofibrosis of a significant proportion of lung tissue, due to the outcome of granulomas in the scar tissue, as well as the appearance of confluent lesions on both sides.

Process activity

The course of sarcoidosis can be of three varieties, however, like any chronic disease:

  • active phase or acute phase - characterized by the emergence of new foci of the disease;
  • process stabilization phase;
  • phase of inflammation regression. The most favorable outcome is a traceless resorption of granulomas. Other forms are fibrosis, as well as the formation of calcinates.

In addition, the rate of development of the disease is important - it can be erased or slowed down, a fast or slow progressive variant of the development of inflammation.

Symptoms and signs of lung sarcoidosis

Symptoms and signs of lung sarcoidosis

Signs of pulmonary sarcoidosis are non-specific. This means that instead of granulomatous inflammation, any process could be of any kind - the nature of the disturbances is due only to the fact that the nodes “interfere” with the work of the lungs by the very fact of their presence.

It is impossible to diagnose Beck's disease for only one symptom, since they can be interpreted too broadly:

  • lethargy, weakness;
  • decreased performance;
  • unreasonable weight loss;
  • decreased appetite;
  • night sweats;
  • low-grade fever;
  • violation of sleep.

As can be seen from the list - these signs are characteristic of a large group of various diseases, from myocarditis to HIV infection.

With a significant development of the process, symptoms occur that indicate the defeat of the bronchopulmonary system:

  • the emergence of cough and rales of different sizes;
  • the occurrence of shortness of breath;
  • the appearance of joint pain;
  • recurrent chest pains and a feeling of squeezing or foreign body behind the sternum.

As a rule, it is these symptoms that cause the doctor to send the patient to an x-ray examination, where “suspicious shadows” are found.

But there is also a completely asymptomatic course of sarcoidosis of the lungs, especially in the early stages or in the case of an isolated lesion of one group of lymph nodes.

Diagnosis of pulmonary sarcoidosis

Sarcoidosis of the lungs and intrathoracic lymph nodes refers to diseases that can be exposed immediately from the results of X-ray examination, but require long-term confirmation.

Decisive "point" in the diagnosis allows you to put a biopsy of the lung.

The main "reference points" of diagnosis are:

  • detection of inflammation in the blood;
  • change in the amount of γ-globulins;
  • characteristic X-ray picture when examining the lungs;
  • biopsy performed, as a rule, during bronchoscopy.

The histological picture shows epithelioid granulomatous inflammation.

Therefore, those who think that lung sarcoidosis is cancer are mistaken. No tumor cells are found in Beck's disease.

Treatment of lung sarcoidosis

Treatment of lung sarcoidosis

Most often, after the diagnosis is established, the patient is simply observed, since spontaneous remissions are possible. Prescribed treatment only for severe, as well as with a significant progression of the disease.

Since sarcoidosis of the lungs is similar to tuberculosis, then TB doctors and rheumatologists are involved in the treatment of this disease.

The main drugs that are shown in this disease are corticosteroid hormones, as well as non-steroidal anti-inflammatory drugs, which are characterized by a pronounced anti-inflammatory effect (indomethacin).

In resistant cases, cytostatics and immunosuppressants are prescribed.

Since all of these drugs adversely affect the stomach, during treatment, one has to take drugs - proton pump blockers for the prevention of ulceration, for example, omeprazole.

With a favorable outcome of treatment, the patient after two - three years is removed from the dispensary registration.

Complications of sarcoidosis

Contrary to rumors, lung sarcoidosis does not turn into cancer, but the inflammatory process may be complicated by the following conditions:

  • the development of chronic respiratory failure;
  • the appearance of a "pulmonary heart" due to stagnation in the pulmonary circulation;
  • since the development of inflammation weakens the immune system, sarcoidosis can be the cause of the adherence of tuberculosis;
  • pronounced outcome in fibrosis can significantly reduce the area of ​​the lung, this phenomenon is called "cellular lung". This condition is manifested by the appearance in the lung tissue of small cavities, which are manifested by respiratory failure.

When treating sarcoidosis, be sure to stop smoking.

Diet and nutrition

Beck's disease refers to those conditions in which the concentration of calcium ions in peripheral blood increases. Therefore, it may increase the risk of stone formation in the kidneys, bladder.

You need to refrain from those foods that contain calcium - for example, from milk and cheese. Otherwise, food should be complete and easily digestible.

Prevention of lung sarcoidosis

Prevention of lung sarcoidosis Since the causes of the disease are unclear, it is impossible to carry out “targeted prevention”.

Since there are well-known groups of professions that are more prone to the development of the disease, the main instrument is the annual x-ray, spirography and timely visit to the doctor when the obscure and "insignificant" symptoms described above appear.

The importance of compliance with sanitary standards in the workplace and the use of individual respiratory protection.

Hardening, swimming, improving the body's immunity, timely taking vitamins - all this increases the chances that a person does not get sarcoidosis.

ICD 10 classification

According to the existing classification of diseases 10 revision, pulmonary sarcoidosis (ICD 10) is coded as D 86.

The section where it was placed is called "individual disorders affecting the autoimmune mechanism." This indicates confusion, due to the unclear nature of the causes of the disease.

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