Stages of Sarcoidosis
Sarcoidosis is divided into stages according to the X-ray findings:
- Stage 0: no changes, but another organ has sarcoidosis.
- Stage 1: bihilary lymphadenopathy (enlarged lymph nodes on both sides of the lung root), approx. 70% chance of spontaneous remission.
- Stage 2: Stage 1 plus nodular changes in the lungs, approx. 40% chance of spontaneous remission.
- Stage 3: Lung infestation without lymph node enlargement.
- Stage 4: permanent damage to the lung with fibrotic remodelling (more connective tissue). It is also possible to visualize the lung infestation in a computer tomography.
What forms of sarcoidosis are there?
Basically, there are two forms of sarcoidosis: a chronic form, which creeps in slowly, and an acute form of sarcoidosis.In the acute form of sarcoidosis with sudden onset of the disease, a distinction is again made between the so-called Löfgren’s syndrome (after the first describer Sven Halvar Löfgren) and the Heerfordt-Waldenström syndrome. Mostly it is the chronic form of sarcoidosis (95%), only rarely the acute form of sarcoidosis (5%). In contrast, the acute forms of sarcoidosis, Löfgren’s syndrome and Heerfordt-Waldenström syndrome, are typically characterized by very specific symptom complexes.
In Löfgren’s syndrome (sarcoidosis) one speaks of so-called symptom triad, i.e. a combination of three different symptoms: Bihilar lymphadenopathy is a pathological swelling of the pulmonary lymph nodes in the region of the lung root (hilus), in both lung wings. An erythema nodosum is also known as nodular rose and is characterized by multiple granuloma formation (i.e. nodule formation) in the subcutaneous fatty tissue. Mostly ankle, knee and lower leg are affected.
Since the nodules are the expression of an inflammatory reaction, they are usually painful, reddish in color and are sometimes accompanied by fever and a general feeling of illness. Polyarthritis is an inflammatory joint disease that affects at least five or more joints, usually joints that are symmetrically opposite each other. A few weeks before the development of erythema nodosum and polyarthritis, flu-like symptoms such as chesty cough, a reduction in physical performance and a general feeling of illness often occur.
- Bihiliary Lymphadenopathy
- Erythema nodosum
- Polyarthritis
The very rare Heerfordt-Waldenström Syndrome, like Löfgren’s Syndrome, is characterized by a certain complex of symptoms: Here, a parotid swelling is a swelling of the parotid gland, an anterior uveitis is an inflammation of the iris and ciliary muscle in the eye, a fascial nerve paresis is a functional disorder of the facial nerve with paralysis of the mimic muscles in the facial region. Without therapy, the acute symptoms last for several weeks and then disappear spontaneously and completely.
- Fever,
- Parotid swelling
- Anterior uveitis and
- Fascial nerve palsy.
