Sarcoidosis is a rare condition in which granulomas develop throughout the tissues of the body. It is likely the result of an immune response in the body, which may be triggered by an inhaled substance. While it predominantly impacts the lungs, the granulomas may develop in any tissue in the body. This paper will discuss the care of a patient who suffers from chronic sarcoidosis and has an exacerbation of symptoms. In this case study, a thirty-six year old female with sarcoidosis presents with shortness of breath (dyspnea) and blurred vision. Both of these symptoms may be related to her primary diagnosis of sarcoidosis.
Sarcoidosis is noted for the development of non-caseating granulomas. While the etiology of the disease is currently unknown, it is believed to be environmental in nature. While the granulomas are predominantly found in the lungs, any tissue in the body may be involved. The dominant signs and symptoms depend upon what body system is involved. Pulmonary complaints, such as dyspnea, are present in approximately fifty percent of all cases. However, individuals may also developed blurred vision in cases of ocular sarcoidosis and life-threatening cardiac events as a result of cardiac sarcoidosis (Kamangar, 2015).
Sarcoidosis is a relatively rare condition. However, the incidence of the condition does differ in various racial and ethnic groups. Furthermore, some individuals are more likely to suffer from the condition as a result of job-related exposures. There is scant data on the true incidence and prevalence of the condition in various populations though. Among women in the United States, the incidence is eleven cases per 100,000 individuals (Dumas, Abramovitz, Wiley, Cozier, et al, 2016). The incidence of men African-Americans are more likely to suffer from the condition and have an incidence of 34 cases per 100,000 individuals. Individuals, particularly firefighters, who worked at the site of the World Trade Center tragedy have been found to have a greater risk for developing the condition (Kamangar, 2015).
Individuals who are suspected of having sarcoidosis should have a basic physical and examination, as well as basic laboratory blood work. However, the individual should also have tests for serum amyloid A (SAA), soluble interleukin-2 receptor (sIL-2R), lysozyme, angiotensin-converting enzyme (ACE). A chest x-ray is required. It may show air trapping. It may also show hilar lymphadenopathy, a classic finding of the condition (Kamangar, 2015). Pulmonary function tests may indicate the severity of the lung involvement; however, they are not diagnostic for sarcoidosis. Individuals who are in high-risk occupations, such as firefighters or those who worked at the WTC site, should be routinely screened for the disease.
Sarcoidosis is a chronic condition. Individuals with the condition should receive thorough patient education regarding the disease. While there is no known cure, there are treatments available. Individuals who smoke should be advised to quit. In addition, nurses should encourage the patient to engage in regular aerobic activity to improve the lung function and reduce the fatigue (Salligan, 2014, p. 2376). Two commonly used medications include prednisone, which reduces inflammation and ibuprofen, which helps to relieve the joint inflammation and pain associate with the condition. Concerns with prednisone include weakening the patient’s immune system, as well as weight gain. Motrin is a commonly used over-the-counter medication; it should not be used by individuals with liver concerns. Motrin costs only a few dollars for a large bottle and generic is available. Prednisone is also relatively inexpensive and is available at Walmart.
The prognosis of sarcoidosis depends upon what body tissue is involve. Since this patient is experiencing lung involvement, she is likely to have a decreased quality of life. However, the overall mortality rate of sarcoidosis remains relatively low at one to five percent (Kamangar, 2015).
Sarcoidosis is a multisystem inflammatory disease of unknown etiology. It has been associate with inhaled toxins though. Individuals with the condition, such as the patient in this case study, often develop respiratory complaints. Lung tissue is the most commonly affected tissue. However, any tissue may become involved.
- Dumas, O., Abramovitz, L., Wiley, A. S., Cozier, Y. C., & Camargo, Jr, C. A. (2016). Epidemiology of Sarcoidosis in a Prospective Cohort Study of US Women. Annals of the American Thoracic Society, (ja).
- Kamangar, N. (2015, July 30). Sarcoidosis, Retrieved from: http://emedicine.medscape.com/article/301914-overview
- Saligan, L. N. (2014). The relationship between physical activity, functional performance and fatigue in sarcoidosis. Journal of clinical nursing, 23(15-16), 2376-2379.