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Steroids for Treating Sarcoidosis an Option but Far From Ideal

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As more is learned about the treatment of sarcoidosis there is little doubt that steroids are not the final step in the development process. Doctors and researchers are working to find what that next step is.

A lot of times what happens is because it’s often most commonly recognized as a pulmonary condition but more importantly is that we take the time to look for extra pulmonary involvement because that’s where a lot of disabling disease can happen in in the nervous system in the brain in the spinal cord and it’s a great question that you’re asking because here in new

Orleans in about a week and a half a cadre of experts are convening here in new orleans to address some of these questions how can we assist the the general medical community in asking the right questions for every sarcoid patient that comes through the door asking questions that pertain to heart failure asking questions that pertain to visual acuity and getting

Them into the right care so we recognize the symptoms early that could be could be related to sarcoid disease and if we treat early during that inflammatory period then we can prevent that damage and destruction and the scarring that happens which is not reversible the kind of treatments that are available well most commonly patients are treated with steroids and

This enough itself is it’s a big concern first of all we don’t really even have good studies in sarcoid though we we all can see that that it works that it works what happens though is that we have steroids bearing agents that patients who you think or have the potential the likelihood to have progressive disease or extra organ involvement extra pulmonary organ

Involvement these patients should be considered for in very early on for getting on to what we call dmards which is disease-modifying antirheumatic drugs which are steroid sparing steroids come with a lot of morbidity and in some cases mortality and and the classic story of a patient being treated with steroids who has sarcoidosis is that they’ve been left on fairly

High dose steroids for a long period of time and have their hips eaten away have glaucoma have cataracts have osteoporosis so so these are the these are the kinds of questions and gaps in medical knowledge that we’re going to be trying to answer here in new orleans but usually the person who takes care of a person with sarcoidosis tends to be a pulmonologist and

They tend to be focused on the lungs so our goal is to provide a feasible easy reference for them to help manage patients there are rheumatologists also who take care of sarcoidosis it’s not a field that’s really been embraced although it should be because it’s a multi organ system disease my rheumatologists we hope to change that i think perhaps because we don’t

Have a great deal of information and you think it would especially because of the use of steroids which is kind of what we do all the time it gets tricky and and because i think because it is thought of as primarily a pulmonary disease so so i think perhaps the rheumatology community doesn’t get the exposure that they would if there were instant referrals yes it

Can be so i had said that in the majority of patients that it can remit and regress but in in a percentage of patients especially african-americans they could go on to have a very poor prognosis with mortality and that’s mostly related to cardiac disease from from sudden cardiac death and from pulmonary fibrosis but the disability is also high because that in which

Starkly impacts one’s function in that if you have a brain lesion or if you have spinal cord lesions you could be left with devastating deficit deficits

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Steroids for Treating Sarcoidosis an Option but Far From Ideal By HCPLive