iatroX Rounds #14
The clues
- 1
A 34 year old woman presents to her GP with a three month history of a persistent dry cough and feeling increasingly tired.
- 2
She has recently noticed the appearance of painful, tender, red nodules on her shins and some swelling in her ankles.
- 3
She also reports that her eyes have felt gritty and red for several weeks, and she has noticed a significant increase in thirst and urinary frequency.
- 4
Clinical examination reveals bilateral parotid gland enlargement and multiple firm, non tender lymph nodes in the neck and axilla.
- 5
A chest radiograph demonstrates prominent, symmetrical bilateral hilar lymphadenopathy with no evidence of lung parenchymal disease.
- 6
A biopsy of an affected lymph node reveals well formed granulomas that are not caseating and an absence of acid fast bacilli on staining.
Sarcoidosis is a multisystem, chronic inflammatory condition of unknown aetiology characterized by the formation of granulomas that are not caseating. It most commonly affects the lungs and intrathoracic lymph nodes but can involve the skin, eyes, and other organs.
- Bilateral hilar lymphadenopathy
- Erythema nodosum
- Hypercalcaemia
- Granulomas that are not caseating
for education and entertainment. not medical advice.