How Can Sarcoidosis Affect The Eyes?
Treatment with corticosteroids is often to blame.
What Are Parasarcoidosis Syndromes?
Many sarcoidosis patients experience complications or symptoms that are not directly related to granulomas or fibrosis. These are called parasarcoidosis syndromes and they can have a significant impact on a patient’s quality of life.
The main parasarcoidosis syndromes are fatigue, vitamin d dysregulation, erythema nodosum, small-fiber neuropathy, pain syndromes, depression, and cognitive impairment. Fatigue
Fatigue affects a large amount of sarcoidosis patients, even when their other symptoms are under control. Erythema Nodosum
Erythema Nodosum is a skin lesion that develops without granuloma formation.
Sfn has two sub-categories: painful neuropathy and autonomic neuropathy. This can result in pain, numbness, vibrations or electric shock sensations, and dysesthesias. Autonomic neuropathy usually happens along with painful neuropathy.
Much of this pain is not directly related to the formation of granulomas. There is some debate as to whether depression is a parasarcoidosis symptom. Learn about treatment options.
Save Citation To File
Corticosteroids are used as first-line treatment in organ-threatening sarcoidosis. However, sarcoidosis patients are at risk for hypercalcemia, and CAD supplementation affects the calcium metabolism. We studied calcium and vitamin D disorders in a large cohort of sarcoidosis patients and investigated if CAD supplementation is safe.
Retrospectively, data of 301 sarcoidosis patients from July 1986 to June 2009 were analyzed for serum calcium, 25-hydroxy vitamin D (25-(OH)D), 1,25-dihydroxy vitamin D (1,25(OH)2 D), and use of CAD supplementation. Disease activity of sarcoidosis was compared with serum levels of vitamin D. Hypercalcemia occurred in 8%. During CAD supplementation, no hypercalcemia developed as a result of supplementation.
Hypovitaminosis D seems to be related with more disease activity of sarcoidosis and, therefore, could be a potential risk factor for disease activity of sarcoidosis.
Abstract
After the initial description of extrarenal synthesis of 1,25-dihydroxyvitamin D (1,25-(OH) 2 D) three decades ago, extensive progress has been made in unraveling the immunomodulatory roles of vitamin D in the pathogenesis of granulomatous disorders, including sarcoidosis. Recently, a few studies have cast doubt over the mechanisms underlying the development of hypercalcemia in this population.
Consequently, clinical interest has been piqued in the use of vitamin D to attenuate the autoimmune response in this disorder. However, the development of hypercalcemia and the attendant detrimental effects are real possibilities. This review is a concise summary of the literature, outlining past work and newer developments in the use of vitamin D in sarcoidosis.
Keywords: Sarcoidosis, hypercalcemia, kidney stones, vitamin D, autoimmune.