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Sarcoidosis: Granulomas
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Sarcoidosis is an illness that causes tiny islands of inflammatory cells to form throughout the body. These microscopic groups of cells are called granulomas. They are especially common in the lungs, lymph nodes, skin, eyes and liver. The cause of sarcoidosis is unknown.
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Sarcoidosis is a condition in which inflammation that produces microscoptic lumps of cells (called granulomas) in various organs in your body. These tiny granulomas can grow and clump together, which makes many large and small groups of lumps. If many granulomas form in an organ, they can affect how the organ works.
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Sarcoidosis granulomas often produce excessive amounts of vitamin D which is important in regulating calcium in the body. Excessive amounts in the blood or urine can be damaging and cause thirst, tiredness, passing of excessive urine, kidney stones, renal colic or kidney impairment. A 24 hour collection of urine can tell if the amount of calcium in the urine is excessive. This can be treated by reducing the intake of milk and cheese, avoiding excessive sunlight (which increases vitamin D), not taking multivitamins containing vitamin D, and drinking plenty of fluid. Sometimes corticosteroid treatment is necessary.
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Sarcoidosis often starts in either the lungs or the lymph nodes (small organs of the immune system). The inflammation causes granulomas - small lumps in the tissue. For example, small raised patches on the face are a sign that the skin may be affected.
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Sarcoidosis is usually treated with steroids initially. For sarcoidosis of the skin or eyes, the treatment is topical (as a cream or ointment), although injection of steroids into the eye may be needed if serious iritis or uveitis is found. Oral steroids - e.g. prednisone or prednisolone - are used for other forms of sarcoidosis, with treatment lasting from 6-12 months. These drugs suppress the immune system so that the sarcoid granulomas can (hopefully) heal themselves with little or no lasting damage.
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Sarcoidosis can cause high levels of calcium to accumulate in the blood and urine. These high levels occur because sarcoid granulomas produce activated vitamin D, which enhances calcium absorption from the intestine. High blood calcium levels lead to a loss of appetite, nausea, vomiting, thirst, and excessive urine production. If present for a long time, high blood calcium levels may lead to the formation of kidney stones or calcium deposits in the kidney and, eventually, to kidney failure.
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