Diagnosis of Sarcoidosis
Sarcoidosis, an inflammatory disease that strikes the organs, can often impersonate other disease processes. Often, a diagnosis of sarcoidosis is established only after eliminating other diseases. A routine chest x-ray will often lead to the suspicion of a sarcoidosis diagnosis.
A diagnosis of sarcoidosis is given after undergoing several modes of physical assessment. The doctor will start by giving the patient a thorough physical examination. He will discuss your past medical history, any unusual signs or symptoms, skin abnormalities, eye discomfort including redness, and note any swollen areas, such as the lymph nodes. A chest x-ray is done, as this will show whether a patient has sarcoidosis.
A person with sarcoidosis has particles or clumps of tissue that are known as granulomas. These granulomas appear as a shadow on the chest x-ray. Chest x-rays have a classification system as follows: A stage 0 indicates a normal x-ray, stage 1 indicates clear lungs with enlarged lymph nodes, stage 2 indicates shadows in addition to any enlarged lymph nodes, stage 3 indicates no lymph nodes, however, the shadows remain, and a stage 4 indicates a lung with notable scar tissue.
The physician will also order blood tests to be performed. These tests will indicate and examine how many and what particular cells are in the person’s body. They will measure various aspects of the blood such as, proteins, calcium, angiotensin converting enzymes, kidney, liver and bone marrow changes.
The physician will also evaluate a person’s pulmonary functioning. This will determine a great deal about the lungs. This testing procedure is simple, but costly. The lung functioning tests will consist of spirometer testing indicating any scarring in the lung, lung volume, diffusing capacity, and a pulse oximetry test.
Other blood work associated with lung functioning is arterial gases. A bronchoalveolar lavage is done in combination with a fiberoptic bronchoscopy. A BAL is done by infusing saline into the lung area. A fiberoptic bronchoscopy is accomplished by viewing the lung tissue through a tube and further removing a small piece and performing a fiberoptic bronchoscopy biopsy for examination.
In addition, other testing is done on the body including a CT scan, an MR scan, Thallium and Gallium scans, and PET scans. Cardiac and eye testing is also done.
Close and careful monitoring is needed with any disease processing and even though the symptoms of sarcoidosis may wax and wane, it still requires close observation. By seeing your doctor frequently for physical examinations and keeping him or her informed of any signs or symptoms of your sarcoidosis disease the chances of this disease becoming out of control are greatly reduced. See your physician regularly if you are a victim of sarcoidosis for the best possible care in treating your condition.
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