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Tuesday, 12 December 2017

There are over 200 types of rheumatic disease and over nine million people in the UK have some form of arthritis. Arthritis means inflammation of the joints. Most people with arthritis will experience pain and some difficulty in moving around.

Arthritis affects people of all ages, including children. It is not clear what causes it and there is no cure at present. However, treatment can largely alleviate the symptoms and enable people to continue to live an active life, although some modifications may be necessary.

Rheumatic Conditions FAQs

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Sarcoidosis

Sarcoidosis or ‘sarcoid’ is an inflammatory condition affecting people of all ages and races. It is most common in adults between the ages of 20 and 40, especially those of African American, Asian, German, Irish, Puerto Rican or Scandinavian origin. The cause is unknown. Generally sarcoid can be classified as acute or chronic.

In acute sarcoidosis there is usually joint pain, often in the ankles, erythema nodosum (raised red lumps on the skin) and tender and/or swollen lymph glands, particularly in the chest. This form is generally self-limiting and will usually go away with little intervention, other than painkillers or anti-inflammatory tablets.

In chronic sarcoidosis, inflammation leads to the formation of tiny clusters of cells, or granulomas. These may form in almost any part of the body, although the condition usually begins in either the lungs or the lymph nodes, especially those within the chest cavity. The skin, eyes and liver are often also affected. Less commonly the spleen, brain, nerves and heart may be implicated. As the granulomas enlarge they may affect the function of an organ.

Sarcoid has both active and inactive phases. During the active phase, granulomas form and grow, causing symptoms and forming scar tissue within affected organs. In the non-active phase, the inflammation subsides and the granulomas stop growing and may even shrink. However the scar tissue remains and may continue to cause symptoms.

The effects of sarcoid usually develop slowly, over months or years. Symptoms may include shortness of breath, a dry cough, wheezing and enlarged or tender lymph nodes. Other symptoms such as disturbed heart rhythm, arthritis in the ankles and eye symptoms may occur suddenly, however. The course of the disease varies greatly from person to person: many people have no symptoms at all. Others have mild symptoms, which may disappear completely after a few years when the inflammation resolves and the granulomas stop growing or shrink. In some people the inflammation continues but does not get worse, with symptoms flaring and needing treatment from time to time. In others sarcoid progresses slowly over years, with scar tissue eventually causing permanent organ damage.

Treatment is aimed at shrinking the granulomas, relieving symptoms and improving the function of affected organs. Prednisolone, a corticosteroid anti-inflammatory drug, is often given over several months to reduce inflammation. Sometimes other drugs such as hydroxychloroquine, methotrexate, azathioprine and cyclophosphamide are also used to treat the condition.

More information from Sila: The Sarcoidosis Charity