In the list of diseases that are impossibleto get infected from people or animals and which arise due to reasons not clarified until the end, Beck's disease is not the last place. Sarcoidosis is its modern name. It is rarely diagnosed, not more than 150 out of 100 000 people, but it affects people on all continents, and therefore it is assigned an international code in the ICD-10 classification system. This is necessary so that doctors in any country can more easily navigate with the definition of an insidious disease, by joint efforts to seek new methods of treatment and quickly find the right solution when the patient needs help.
Sarco sarcoidosis occurs when in differenthuman organs suddenly begin to divide and transform groups of cells that are capable of phagocytosis. As a result of this process, nodules (granulomas) are formed, which can not manifest themselves in any way or cause a significant deterioration in the state of health. Granulomas can appear in any organ, including the heart, eyes, kidneys, liver, but are most often localized in the lungs. The deaths in sarcoidosis are single and recorded only in very weak patients with low immunity, who were not treated. Approximately in 10% of patients, granulomas dissolve independently without the use of medications. Most people suffering from sarcoidosis require specific treatment and advice from a pulmonologist, cardiologist, ophthalmologist, neurologist, dermatologist, rheumatologist.
For the first time described the sarcoidosis of Beck (Boek), the BritishSurgeon-dermatologist D. Hutchinson. In 1877, he observed two patients: a 53-year-old man and a 64-year-old woman who had purple granulomas on the skin of their legs and hands. Twelve years later, the French doctor Benière described the course of the disease in a patient who had similar granulomas in the nasal region. In addition, this patient had grayish-blue swelling of the ears and fingers. Regardless of Beni, the Norwegian physician Caesar Bök performed a histological study of similar granulomas and gave them the name "benign sarcoidosis of the skin". He also noticed that purple nodules can appear on the mucous membranes and in the lungs, and the Swedish doctor Shaumann tried to systematize data on various manifestations of sarcoidosis. As a result, the ailment was called "Bénier-Beauca-Schaumann disease". This term can still be found in some medical documents.
In the ICD-10 system, Bek's sarcoidosis is classifiedas a disease of the third class. This means that in its etiology involves the violation of immunity. According to the international catalog, this affliction is assigned code D 86. The sarcoidosis of the specific organ affected by the granulomas has the following numbering:
If other diseases are diagnosed in sarcoidosis, the numbering is as follows:
Beck's sarcoidosis can occur in three forms:
1. Chronic. In patients, general deterioration in well-being, causeless weakness, decreased ability to work is noted.
2. Acute. This form is characterized by a sharp temperature jump, an increase in lymph nodes, and swollen joints of the extremities.
3. Subacute. There is a wave-like increase in temperature, the general condition is moderate.
There is also a refractory form (the treatment is not amenable).
The described disease is differentiated according to three degrees of severity:
The first. Patients with enlarged thoracic lymph nodes (bronchopulmonary, tracheobronchial, paratracheal, bifurcation) are observed.
The second. Sarcoidosis of Beck 2 degrees is characterized by the presence of inflammatory interstitial foci in the lungs.
The third.There is fibrosis (pneumosclerosis) of the lung tissue, while the intrathoracic nodes do not increase, but emphysema is formed. Together with the fibrosis foci they form extensive drain conglomerates. Patients complain of chest pain, poor appetite, severe fatigue, lethargy, dry cough, shortness of breath, joint pain.
There is a classification in which five stages of sarcoidosis are distinguished:
Sarcoidosis of Beck MKB of the 10th revision refers todiseases associated with impaired immunity, as a result of multiple studies revealed the role of HLA (human leukocyte antigens) in the appearance of granulomas. Thus, loci are found that protect against sarcoidosis or, on the contrary, its provoking, causing damage to the brain, eyes and other organs.
It is unequivocally established that sarcoidosis is not contagious. The fact that this affliction takes place among members of the same family does not exclude his hereditary transmission.
Perhaps this is all that is absolutely certain aboutetiology of the disease. The final answer to the question about what influences the development of the disease, yet. Scientists suggest that risk factors can be:
If you have not yet established the reasons,causing Becker's sarcoidosis, then the epidemiology of the disease is well known. Thus, it is proved that this disease affects people of any age, including small children, but more often it is observed in patients aged 20-40 years, and more susceptible to women. With regard to race, there is also some difference. Sarcoidosis is extremely rare in the Middle East and Japan, and in India it is diagnosed in 150 people out of 100 000. In northern Europe, 40 people fall out of 100 000, in the southern part the indicators are slightly higher. In Australia, Beck's disease is diagnosed in 92 people per 100,000, in the United States among African Americans the figure is 40-64 cases, and among people with fair skin only 10-14 of 100,000 people fall ill.
It's surprising that smokers are less likely to have sarcoidosis than those who do not have this bad habit.
Sarcoidosis at the initial stages most oftenflows without symptoms. Usually people do not even suspect that they have this ailment. Most clearly, signs are observed even with a disease of grade 3, when the so-called pulmonary-mediastinal form of Beck sarcoidosis occurs. Most patients have such symptoms:
Such complaints are often diagnosed"Cold" or "acute respiratory disease," but as the sarcoidosis progresses, cough becomes protracted, hemoptysis appears, granulomas become visible on the skin. In the future, without treatment, eyes, liver, heart, and other organs may be affected. The symptomatology with each form has characteristic features. So, with sarcoidosis of type D86.8 + H22.1 * vision deteriorates, eyelids become inflamed, lacrimation appears. At type D86.8 + I41.8 * there are signs of heart failure, dyspnea, arrhythmia. In type D86.3, erythema nodosum appears on the skin. They can resemble a rash. The face, forearms, shins are touched.
Sarcoidosis has symptoms similar tomanifestations of other diseases. In order to correctly differentiate it, the patient is required to examine and consult many narrow-profile doctors and a series of tests to exclude:
The patient is analyzed:
Ultrasound in Beck's sarcoidosis is transesophageal, giving excellent results when examining the intrathoracic lymph nodes. At the same time, a biopsy is performed.
Another type of survey - scanning withgallium. This metal is peculiar to accumulate in the foci of inflammation. After 2 days after intravenous administration, the patient's substances are scanned. The disadvantage of the method is that gallium is able to accumulate in any inflammatory foci, regardless of whether they are caused by sarcoidosis or another disease.
The purpose of therapy for this disease is to preserve the functions of all affected organs. If a patient has lung scars in his lungs, it is no longer possible to get rid of them.
When all analyzes are confirmeddiagnosis of "sarcoidosis", the doctor prescribes glucocorticosteroids. The main drug is Prednisolone. The course of treatment is long, up to 8 months. There may be side effects:
When taking the drug very quickly a positive effect is observed, but after the cessation of therapy the signs of the disease can return.
In the complex appoint "Pentoxifylline", "Methotrexate", "Chloroquine".
Given the fact that granulomas canto disappear, patients who do not get any discomfort or pain, sarcoidosis, do not prescribe treatment, but regularly monitor their health.
If the diagnosis of "Beko sarcoidosis" is establishedthe results of CT, lung radiography, biopsy analysis, there can be no mistake, but you do not need to despair. This disease with proper treatment does not reduce the standard of living, does not affect the ability to work, and women with such ailment without problems give birth to healthy children.
Complications occur only in those patients who have not been treated in a timely manner. They may have:
Prevention of sarcoidosis has not been developed due to the uncertainty of its etiology. Doctors give only general recommendations:
