sarcoidosis and fatigue

Q:  History of high fatigue in a patient with sarcoidosis points towards? (select one)

A) Pulmonary Sarcoidosis
B) Extra-pulmonary Sarcoidosis


Answer: B

Fatigue is a common complaint in patients with most of the sarcoidosis patients. It is very interesting that higher level of fatigue in sarcoid patient is found to be associated with presence of extrapulmonary sarcoidosis. In other words, though sounds paradox but fatigue is less pronounced in patients with only pulmonary sarcoid. Further investigation also showed that patients with extra-pulmonary sarcoidosis have higher resting energy expenditure and increased C-reactive protein (CRP).

#metabolism
#pulmonary


References:

1. de Kleijn WP, De Vries J, Lower EE, et al. Fatigue in sarcoidosis: a systematic review. Curr Opin Pulm Med 2009; 15:499. 

2. Fleischer M, Hinz A, Brähler E, et al. Factors associated with fatigue in sarcoidosis. Respir Care 2014; 59:1086. 

3. Drent M, Wirnsberger RM, de Vries J, et al. Association of fatigue with an acute phase response in sarcoidosis. Eur Respir J 1999; 13:718.