Light lung nodules

Many people do not pay much attention to their bodies, especially young people. In many cases, they do not pay special attention to a little discomfort in their bodies, and think that it will go away after a short period of resistance. Finally, when they have a physical examination, they find a lot of problems. This article takes lung nodules as an example. The early symptoms of lung nodules are not obvious. It may just be an occasional cough accompanied by a little sputum, which can be easily ignored. The article introduces the clinical manifestations of this disease in detail. Let's take a look.

Clinical manifestations

Symptoms and signs vary depending on how quickly they develop and which organs are affected. In the early stages of intrathoracic sarcoidosis, there are often no obvious symptoms and signs. Sometimes there is coughing, coughing up a small amount of sputum, and occasionally a small amount of hemoptysis; there may be fatigue, fever, night sweats, loss of appetite, weight loss, etc. When the lesions are extensive, chest tightness, shortness of breath, and even cyanosis may occur. The condition may be aggravated by concurrent infection, emphysema, bronchiectasis, cor pulmonale, etc. If sarcoidosis affects other organs at the same time, corresponding symptoms and signs may occur. For example, the most common skin disease is erythema nodosum, which is often seen on the face, neck, shoulders or limbs. There is also lupus pernio, macules, papules, etc. Subcutaneous nodules are sometimes found. Violations of the scalp can cause hair loss. About 30% of patients may experience skin lesions. About 15% of cases suffer from eye damage, which may include iridocyclitis, acute uveitis, keratoconjunctivitis, etc. Symptoms such as eye pain, blurred vision, and ciliary body congestion may occur. Some patients have liver and/or spleen enlargement, slightly increased bilirubin and alkaline phosphatase, or liver damage. Mediastinal and superficial lymph nodes are often invaded and swollen. If the joints, bones, muscles, etc. are affected, there may be polyarthritis, and X-ray examination may show multiple small cystic bone defects (bone cysts) in the short bones of the limbs, hands and feet. Muscle granuloma can cause local swelling, pain, etc. About 50% of cases involve the nervous system, and the symptoms vary widely. Clinical manifestations may include cranial nerve paralysis, neuromyopathy, space-occupying lesions in the brain, meningitis, etc. When sarcoidosis affects the myocardium, it may cause arrhythmias or even heart failure. About 5% of cases involve the heart. Pericardial effusion may also occur. Sarcoidosis can interfere with calcium metabolism, leading to increased blood calcium and urine calcium, causing renal calcium salt deposition and kidney stones. When the pituitary gland is involved, it can cause diabetes insipidus, and when the hypothalamus is involved, excessive milk production and elevated serum lactogen can occur. When the parotid gland, tonsils, larynx, thyroid gland, adrenal gland, pancreas, stomach, reproductive system, etc. are affected, related symptoms and signs may occur, but this is less common. Sarcoidosis can affect one organ or multiple organs at the same time.

Disease treatment

1 Treatment principles

1.1 Since most patients can recover on their own, patients with stable conditions and no symptoms do not need treatment. Patients with obvious symptoms in stages II and III and extrathoracic sarcoidosis, such as ocular sarcoidosis, sarcoidosis invasion of the nervous system, skin and myocardial involvement, persistent increase in blood calcium and urine calcium, and significantly increased SACE levels can be treated with hormones. Commonly used prednisone is 30-60 mg per day, taken orally once (or in divided doses). After 4 weeks, the dose is gradually reduced to 15-30 mg per day, and the maintenance dose is 5-10 mg per day for one year or longer. Long-term use of glucocorticoids should closely monitor the side effects of the hormones. Secondly, chloroquine, methotrexate, azathioprine, etc. can be used as treatment.

1.2 Any drug that can cause increased blood calcium and urine calcium, such as vitamin D, is contraindicated.