Sarcoidosis is a rare and chronic inflammatory condition, in which clumps of immune cells called granulomas build in one or more organs. These granulomas can prevent organs from working as they should, and may cause permanent damage.
The lungs are most commonly affected organ, with some 90 percent of all sarcoidosis patients showing disease activity there. The inflammation can cause pulmonary fibrosis, or scarring, of the lungs and airways, which could lead to other lung conditions, such as bronchiectasis.
What is bronchiectasis?
Bronchiectasis is associated with damage to the airways like scarring, causing them to widen and slacken. This reduces the body’s ability to remove the mucus normally produced to keep the airways moist and to trap inhaled dust and bacteria. When the mucus builds up, it creates an ideal environment for the trapped bacteria to grow, leading to repeat lung infections.
The infections can cause further damage, impairing the lungs’ ability to move air in and out. In severe cases, such damage can lead to a collapsed lung (atelectasis), respiratory failure, or heart failure.
Sarcoidosis and bronchiectasis
Sarcoidosis is normally associated with traction bronchiectasis, a type of bronchiectasis caused by pulmonary fibrosis or the scarring of the lungs, triggered by repeat cases of severe inflammation in the lungs because of sarcoidosis.
However, a case study has attributed bronchiectasis to sarcoidosis itself, and not to scarring of the lungs caused by the disease. The study, published in Respiratory Medicine Case Reports, suggested that the bronchiectasis was a direct result of the granulomas building up in the airway and causing inflammatory damage to the walls of the airway.
Symptoms
The most common signs of bronchiectasis include a chronic cough and increased production of sputum (spit) with or without slimy mucus, pus, and trapped particles.
Other symptoms include:
- Frequent infections
- Breathlessness and wheezing
- Thickening of the skin under the fingernails and toenails (clubbing)
- Fatigue
- Sinus problems
- Cough incontinence, or bladder leakage
More severe symptoms include coughing up blood, chest pain, and joint pain.
Diagnosis
Bronchiectasis may be diagnosed using similar tests to those used to confirm sarcoidosis. These include imaging tests to examine the structures of the lungs, such as an X-ray, computed tomography (CT) scan, or bronchoscopy.
Lung function tests may also be requested to assess the volume and speed of air moving in and out of the lungs, as well as how well oxygen moves from the lungs into the bloodstream.
Other tests include blood tests and a sputum culture, which can check for the presence of bacterial or fungal infections.
Treatment
There is currently no cure for bronchiectasis, but treatments options may help to manage the condition.
Infections are treated using antibiotics. To reduce the number of infections developing, a physiotherapist can recommend techniques to clear mucus from the airways, which may also be aided by the use of mucus-thinning medications.
Bronchodilators, or medicines that widen the airways, may be prescribed to relax muscles there, making it easier to breathe. Oxygen therapy may be required if the blood-oxygen levels remain too low for health.
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