92. When I'm off steroids, my doctor tells
me that I could take up to 12 Advil per day. Is the drug of any
value in treating sarcoid?
Advil is good for pain, particularly musculoskeletal pain. It is
a nonspecific analgesic and anti-inflammatory drug but it is not
used to treat sarcoidosis.
93. Has acupuncture any therapeutic value
in managing sarcoidosis?
Acupuncture does not cure sarcoidosis. If a patient with sarcoidosis
has muscle aches and pains, acupuncture may be of help.
94. Is deflazacort being used in this country?
Besides being "bone sparing". is deflazacort better than
prednisone? Deflazacort is not available in this country [USA].
95. Is hypertension a side effect of long
term therapy of sarcoidosis with prednisone and Imuran?
Prednisone causes salt retention and may cause hypertension. Imuran
does not cause an increase in blood pressure, but it may cause renal
96. Do corticosteroids cause sterility and
Corticosteroids cause weight gain, acne, osteoporosis, hypertension,
diabetes mellitus in susceptible individual, depression and suicidal
tendencies, cataract, skin bruising, and infections. There are many
other side effects and patients should always discuss with the doctor.
Prednisone does not cause either sterility or liver damage.
97. What should be done to help the fatigue
Fatigue in sarcoidosis is common. It is perhaps related to its
cause; some patients respond to prednisone and hydroxychloroquine.
98. Would physical therapy be helpful in
treating joint inflammation and muscle involvement?
Yes, physical therapy along with analgesics and corticosteroids
is very helpful in managing joint involvement.
99. What is the best treatment for sarcoidosis
of the bones and bone marrow?
Prednisone and hydroxychloroquine is an effective combination.
100. If a person has been on prednisone and
azathioprine for over six months and no improvement has been made,
what other alternatives are there?
First, the physician will have to reevaluate the nature of sarcoidosis.
If the lungs are completely scarred no medicine will be effective.
If the disease is active, explore the possibility of giving her
hydroxychloroquine 200 mg BID, methotrexate 15 mg/day, infliximab
3 mg/kg intravenous infusions.
101. Are there any preventative measures
that may be taken to avoid seasonal relapses?
Pulmonary sarcoidosis, unlike hay fever, asthma and other allergic
diseases, has no definite seasonal exacerbations. It is erythema
nodosum that occurs in the spring season. No vaccine or other specific
preventive measure is available.
102. What treatment is used to prevent sarcoidosis
attacking the transplanted organ?
There is no known drug that will prevent sarcoidosis. If the disease
appears in the transplanted organ and the patient has symptoms then
the treatment includes prednisone, hydroxychoroquine, and immunosuppressive
drugs.If patient has no symptoms then he/she should be observed.
103. Is childhood sarcoidosis treated differently
from adult sarcoidosis?
No, the treatment is more or less the same, but immunosuppressive
drugs are avoided in children.
104. Is treatment of enlarged spleen in sarcoidosis
The spleen is commonly enlarged by lymphoma, tuberculosis, leukemia,
and many tropical infections. In sarcoidosis enlargement is less
frequent. If an enlarged spleen causes anemia, low platelets, and
leucopenia then treatment is required. An extremely enlarged spleen
may need to be taken out surgically.
105. I have read that the patients with sarcoidosis
should not take vitamin-D; it might worsen the disease. Is this
It only applies if your calcium level is very high. If your vitamin-D
is low then it should be corrected because deficiency of vitamin
D is dangerous.