Sarcoidosis or Boeck’s disease is a rare disease that mainly manifests itself as inflammatory granulomas (small nodules). Although any organ in the human body can be affected by sarcoidosis, the lymph nodes and lungs are more commonly affected. The exact cause of Boeck’s disease is not yet sufficiently known, but various environmental factors are assumed.
What is sarcoidosis?
Sarcoidosis, which is also known as Boeck’s disease in medical circles, is one of the diseases that mainly affects soft tissue structures due to the course it takes and the organ systems that are predominantly affected. In addition to the lung tissue and lung structures, the skin, eyes, bone system, other organs such as the spleen and liver, and the vital heart can all be affected by sarcoid. Some disease processes have shown that sarcoidosis also extends to the nerves and pancreas. See wholevehicles for What are the Meanings of Intrusion.
Sarcoidosis is characterized by the formation of nodule-like masses of tissue that are foci-like. These accumulations of tissue and cells are also known as granulomas because, histologically speaking, they have a misshapen surface. Sarcoidosis can represent a special reaction of the immune system, which manifests itself in a concentration of cellular defense elements. The sarcoidosis disease is mainly observed between the ages of 20 and 40 years.
Causes
Initially, the causes of sarcoidosis, also known as granulomatosis, are only guesswork, because the disease itself and how the human immune system works have not yet been adequately researched. In addition to the body’s immune-controlled activities, it is believed that sarcoidosis is genetic. Various environmental factors may also contribute to the development of sarcoidosis.
Symptoms, Ailments & Signs
The symptoms of sarcoidosis depend on the organ system affected, and those affected often remain completely symptom-free. As a rule, the disease manifests itself in the insidiously beginning chronic form: Its non-specific signs include general malaise, joint pain and weight loss, and the body temperature may be slightly elevated.
Symptoms of the frequently occurring pulmonary sarcoidosis can be exercise-related shortness of breath and chronic dry cough, swelling of the lymph nodes in the chest is often only discovered by chance during an X-ray examination. If Boeck’s disease affects the eyes, inflammation of the iris typically develops, which is accompanied by photophobia and eye pain.
Involvement of the skin becomes noticeable through characteristic skin changes: Typical for a nodular rosette is the strongly painful formation of nodules in the subcutaneous fatty tissue associated with reddening of the skin, mainly on the lower legs. Bluish-purple skin discoloration (lupus pernio) on the face also occurs.
A pronounced attack on the heart often results in cardiac arrhythmias that require treatment or cardiac insufficiency. In the kidneys, sarcoidosis promotes the excretion of calcium and thus the formation of urinary stones. Rarely, neurosarcoidosis appears in the form of meningitis or paralysis of the facial muscles (facial paralysis).
Acute sarcoidosis is characterized by a sudden onset of fever and severe fatigue, typically accompanied by the skin changes described as nodular rosette, joint inflammation in the ankle, and swollen lymph nodes in the lungs.
Bluish-purple skin discoloration (lupus pernio) on the face also occurs. A pronounced attack on the heart often results in cardiac arrhythmias that require treatment or cardiac insufficiency. In the kidneys, sarcoidosis promotes the excretion of calcium and thus the formation of urinary stones. Rarely, neurosarcoidosis appears in the form of meningitis or paralysis of the facial muscles (facial paralysis).
Course of the disease
Acute sarcoidosis can be initiated by the sudden onset of fever and the general symptoms of infection. These general signs of illness are tiredness, severe exhaustion, loss of appetite and body aches. Granulomatosis can only be definitively diagnosed by specific clinical pictures that occur in the affected organs. Heart and respiratory problems, impairment of digestion and the immune system as well as changes in the blood count and altered liver values indicate the existence of sarcoidosis.
In addition to the acute form, chronic sarcoidosis is more likely to be recognized by its gradual course. Some patients suffer from sarcoid and do not show any symptoms. In the context of a possible impairment of respiratory and lung function, an accumulation of granulomas can often be diagnosed in the evaluation of an X-ray image. This is a clear indication of sarcoidosis. Some of the nodules are so small that they can only be seen individually under a microscope. Some of them can also be found in the lymph nodes. In addition, joint pain in the ankle, hematoma-like spots on the lower legs and inflammation of the iris appear as clear signs.
Complications
Chronic sarcoidosis can cause various complications as the disease progresses. Which symptoms occur in detail depends on which organ is affected. In the area of the lungs, Boeck’s disease can trigger pulmonary fibrosis, which leads to changes in the heart and ultimately to right-sided heart failure.
Nodule formation in the area of the kidneys leads to renal insufficiency and associated damage to the kidney tissue, cardiac arrhythmias and disturbances in bone metabolism. If the eyes are affected, visual disturbances occur during the course of sarcoidosis and complete blindness can result. Furthermore, the chronic form of the disease can lead to permanent paralysis, spleen diseases, skin damage and other complications.
Acute sarcoidosis usually does not result in long-term symptoms. In the treatment of both forms, side effects are conceivable. The cortisone preparations prescribed for an infestation of the eyes, liver, skin, heart and nerves can lead to nerve damage and gastrointestinal problems, for example. Anti-inflammatory and pain-relieving drugs also harbor corresponding risks. People who are physically weak and patients who are already taking other medications are particularly at risk. Serious complications usually do not occur.
When should you go to the doctor?
Symptoms such as muscle and joint pain, fever and a general feeling of illness can indicate sarcoid. A doctor’s visit is indicated if the symptoms persist for several days or even become more intense. If the typical nodules appear on the mucous membrane, a doctor must be consulted. If the symptoms occur after inhaling chemicals, fine dust, bacteria, fungi or allergy-causing substances, it is best to see your family doctor immediately. People with lung diseases are also among the risk groups and should consult the doctor if the symptoms described occur.
In addition to the family doctor, the complaints can be taken to a pulmonary specialist or a dermatologist, depending on the symptoms and the location of the nodules. Children should be presented to the pediatrician immediately if breathing difficulties or skin and mucous membrane changes occur. Boeck’s disease requires comprehensive treatment that must be closely monitored. The doctor must be informed about symptoms and complaints as well as any side effects caused by the prescribed medication in order to rule out complications.
treatment and therapy
The basis of the treatment of sarcoidosis is medication. These are mainly needed in the chronic course, the acute sarcoidosis usually hardly needs to be treated. In addition to medicines to reduce fever temperatures, conventional medicine also has substances available as medicines that prevent inflammatory processes in the body.
Since the granulomatosis is associated with painful impairments, which in the case of the joints are predominantly similar to the conditions of arthritis, painkillers are administered. So-called non-steroidal substances have proven their worth in this context. These are known as acetylsalicylic acid and ibuprofen.
The therapy always depends on the individual severity of the disease and the impairments of other organs that occur. If the granulomas appear on the eyes, nerves and kidneys, then the highly effective cortisone is used as a remedy. The good effect of cortisone is that the strong immunological activities are slowed down. If cortisone is poorly tolerated or not tolerated at all, the doctor can also prescribe methotextran or azathioprim.
Aftercare
The type of course (acute or chronic) and the severity of the symptoms are decisive for the aftercare of sarcoidosis (Boeck’s disease). In the case of the acute form (30 percent of cases), aftercare includes continuing the therapeutic measures started until the disease has healed. In about 95 percent of acutely ill people, sarcoidosis heals completely. The nodules resolve spontaneously within a few months.
Regular visits to the general practitioner or pulmonologist may be necessary until the acute illness has healed. In the remaining five percent of cases of acute sarcoidosis, the affected person dies. The focus of aftercare is then on the therapeutic treatment of the bereaved. In order to cope with the grief, a psychotherapeutic consultation is generally recommended by a doctor for the bereaved.
In the chronic course of sarcoidosis (70 percent of cases), depending on the severity of the disease, the function of the lungs remains permanently restricted in 20 to 30 percent of those affected. Follow-up care focuses on damage to the lungs. Regular lung function tests are therefore urgently needed, also in order to detect a possible deterioration in lung function at an early stage and to be able to treat it in good time.
In addition, appropriate rehabilitation measures and endurance sports can improve the performance of the lung function in individual cases. For rehabilitation measures, clinics located by the sea are recommended.
You can do that yourself
Although the cause of the disease has not been fully clarified to this day, the results of various studies and the course of the disease are showing the first indications that the immune system is involved . Therefore, in the field of self-help, the body’s own defense system should be strengthened.
Sufficient exercise, a healthy diet rich in vitaminsand good sleep hygiene promote the activity of the organism. The movement options are to be checked to ensure that no situation of excessive demands occurs. Consuming fresh foods and avoiding unhealthy meals can do a lot to improve well-being. The consumption of alcohol and nicotine should generally be avoided. Stays in the fresh air and sufficient rest are also advisable. If symptoms arise, periods of rest should be taken. Sleep hygiene should be checked at regular intervals and optimized if possible. It is important to ensure an appropriate room temperature, optimal sleeping utensils and the avoidance of disturbing noises.
In everyday life, stress and hectic pace should be reduced to a minimum. Long-term studies have shown that these demonstrably weaken the human organism and thus the immune system. When reading, writing or watching TV, make sure the lighting conditions are right. Many patients complain about eye pain and bright light.
