Sarcoidosis Patient Assessment and Resource Companion App for Fatigue

A recent treatment trial with naltrexone, a drug that inhibits neuronal transmission, reduced sputum production and reduced pain without affecting lung or systemic manifestations of sarcoidosis.

A variety of lung lesions can be found in sarcoidosis. A chest radiograph, pulmonary function testing, and chest MRI are useful in excluding pulmonary tuberculosis. Lung biopsy is of no additional help. Clinical status is the most important determinant of prognosis, and there is a high incidence of chronic lung disease.

It is likely that sarcoidosis results from a complex interaction of both genetic and environmental factors. Sarcoidosis is sometimes described as a hypersensitivity reaction, but that view is erroneous. Sarcoid is a benign disease, as long as patients avoid drugs and other stimuli that might trigger a sarcoid reaction that may have serious side-effects. The immunology of sarcoidosis is still largely unknown.

Many patients with sarcoidosis have positive T-cell immunostimulation results that require active, immunosuppressive therapy for management. The incidence of sarcoidosis among blood donors is not well understood, but the likelihood that positive T-cell immunostimulation test results can justify restricting blood donation remains questionable given the low risk for developing sarcoidosis. The use of corticosteroids is not without risk although they are commonly used in sarcoidosis. The majority of patients are treated with corticosteroids but the rate of relapse is high. Antipsychotic drugs such as Halcion are often prescribed to psychotic sarcoidosis patients for the purposes of treatment of hallucinations and depression.

About 25,000 people are diagnosed each year with sarcoidosis in the United States. Males are much more commonly affected than females. Nonunion of the fingers and facial nerve may occur in sarcoidosis. The risk of developing sarcoidosis increases with exposure to environmental tobacco smoke and with a family history of sarcoidosis.

Sarcoidosis affects almost 10 million people worldwide, and is often undetected, with symptoms that are similar to infectious and malignant diseases. Its signs and symptoms, both internal and external, must not be confused with tuberculosis, tuberculosis of the sarcoid (TB), and lymphoma, so this is especially critical when diagnosis is needed. \n

The average age of diagnosis was 34.1 years. It is important to recognize sarcoidosis in those older than 50 years (n=11). The average disease duration was 16.2 years (n=36). Both age and duration of the disease are significant clinical factors to consider when dealing with sarcoidosis. It had a prevalence of 4.4 cases for every 1000 in Caucasians, while in African Americans the prevalence rate was 19 cases per 1000.

In particular a patient companion interface will be an effective system for patient and doctor communication. The app can be used to exchange questions and patient data and to provide a patient resource. It also helps patients make good first contact. Patients found the app helpful in their medical care and are willing to use the app for long-term follow-ups or to provide patient advocates at the start of care. This app would be especially useful for patients with sarcoidosis as it was well liked and helps patients to manage their health but it can be useful in the majority of patients that are not seriously ill but just need a patient advocate and support.

Findings suggest that sarcoidosis patients are willing and eager to utilize a sarcoidosis patient assessment and resource companion app developed based on the patient-oriented approach.

A free, iPhone applications (CSAR) has been successfully combined in one practice with either oral or topical GCs in this tertiary sarcoidosis clinic, with positive clinical and patient-reported outcomes. The CSAR is intended for use in a sarcoidosis management program that includes a patient assessment and resource companion app that is used along with other treatment modalities and is based on patients' goals for treatment.

Clinical trials are an exciting approach to new treatments for sarcoidosis, as has been shown in the treatment of severe chronic obstructive pulmonary disease. Clinical trial eligibility criteria are defined by patient demographics, disease characteristics and treatment type. All of these considerations should be addressed in future research to create a more efficacious treatment option for sarcoidosis. Clin Trial Registry. ClinicalTrials.gov (NCT00256618).