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Thursday, August 7, 2008

Bernie Mac has it: what is sarcoidosis?

Because of comedian Bernie Mac, new attention is focusing on sarcoidosis, a little known medical condition that affects tens of thousands of Americans.

Mac, currently hospitalized in Chicago with severe pneumonia, has the condition but has been in remission since 2005. His publicist, Danica Smith, says sarcoidosis isn’t responsible for Mac’s current illness.

But people interested in Mac's condition are searching the Web, looking for more information on this little-known disease. So, here's a primer.

Sarcoidosis is an immune system disorder that can make it hard to breathe, inflame lymph nodes in the neck and the chest, and cause bumps and ulcers to break out on people’s skin.

Most cases are mild, but those that are severe can cause serious scarring in the lungs, a complication that occurs in 20 to 25 percent of patients.

It’s not clear what causes sarcoidosis, though experts believe environmental contaminants can help trigger a genetic susceptibility.

Research studies have found an association between this condition and irritants such as tree pollen, insecticides and moldy environments, the New England Journal of Medicine reported in an overview published last November.

Sarcoidosis is “probably the end result of immune responses to various ubiquitous environmental triggers,” the overview stated.

Typically, our bodies fight perceived threats by mounting an inflammatory response. With sarcoidosis, this response becomes excessive and ends up producing small clumps of cells that can cluster together throughout the body.

If these clusters become large enough, they can begin to interfere with the functioning of various organs. Most commonly affected are the lungs (more than 90 percent of cases), the eyes and the skin.

In the worst cases, inflammation causes irreversible lung scarring, serious eye conditions such as cataracts and glaucoma, or aching and swelling in the legs accompanied by arthritis.

Two-thirds of sarcoidosis patients generally go into remission within a decade of being diagnosed; recurrence of the disease after a year of remission affects fewer than 5 percent of patients, the New England Journal of Medicine reported.

One-third of patients have an "unrelenting," progressive form of this illness that typically leads to organ impairment.

This is primary an illness of adults in the 20- to 40-year-old range. African-Americans are more prone to the condition than whites (the incidence rate among blacks is 35.5 cases per 100,000; among whites it’s 10.9 per 100,000). African-Americans women are twice as likely as men to be struck with the illness.

Symptoms include a persistent cough, shortness of breath, fatigue, night sweats, weight loss, small red bumps on the face, arms or buttocks, red, watery eyes, and arthritis in the ankles, elbows, wrists and hands, according to the Mayo Clinic.

There is no cure for this illness. The most common treatment is Prednisone, a steroid that can have serious side effects. Occasionally, physicians prescribe medications known as immune system suppressants (such as Plaquenil and Methotrexate).

While sarcoidosis can be severe, fewer than 5 percent of patients die f
rom the condition. In the vast majority of cases, symptoms are mild and disappear over time.

Original here

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