To ascertain efficacy of Homoeopathy in treatment of sarcoidosis, 50 cases during the period since 2007-2013 were selected for study at Homoeo Cure and Research Institute., Kashipur (INDIA). The efficiency of homoeopathic treatment was miraculously seen in all the cases. Almost all were either cured or much relieved.
Aims and objectives
- To study scope of Homoeopathy in treatment of ‘Sarcoidosis’ with its miasmatic analysis.
- To analyze the results of Homoeopathic medicines when prescribed on the basis of Miasms and on totality of symptoms.
- To prepare an evidence based report on the treatment of Sarcoidosis with Homoeopathy.
‘Sarcoidosis’ is a ‘not well understood’ complex multisystem, commonplace inflammatory disease, characterized by the formation of noncaseating granulomas. The granuloma is a battle clashed on a genetically susceptible ground between an unrecognized antigen(s) and a highly organized squad of lymphocytes and macrophages. The lungs are the most commonly involved organs, but no structure of the body is known to be immune to its wrecks.
The cause of sarcoidosis is not known. Though not common, it often leads to permanent failure or disabilities of the organs ultimately leading to the end of vital functions.
‘Sarcoidosis’, like other disease, affects the person as a whole irrespective of the cause. The whole economy of the patient is altered producing the signs of ‘Sarcoidosis’ as well as a characteristic picture of sick individual including mental and physicals specific to his personality. This disease picture specific to that particular patient is always different from that in another one, due to his particular identity proving him to be an ‘Individual’. The totality of symptoms depends upon the Miasms under-running the disease process in that individual.
The Psora being the fundamental miasm plays a maximum role in altering the physiology and rendering the entire imbalance. While in combination with other miasms, it produces the worst stage of the sickness. The syphilis produces destruction of tissues. To combat it, Sycosis and Psora play their vital part. This combination in turn increases the destruction as well as new tissue formation too, producing granulomas and fibromas publishing the complete portrait of Sarcoidosis.
This article examines the current understanding of sarcoidosis in terms of Homoeopathy.
Definition of Sarcoidosis
“Sarcoidosis is a disease characterized by the formation in all of several affected tissues of epithelioid-cell tubercles without caseation though fibrinoid necrosis may be present at the centre of a few, proceeding either to resolution or to conversion into hyaline fibrous tissue”.
Epidemiology of Sarcoidosis
- Age at presentation 20–40 years
- More common in females and black people
- Present throughout the world, but more common in temperate climates
Causes of Sarcoidosis
Possible Causes of Sarcoidosis
|Tuberculous||Corynebacterium spp.||Cryptococcus spp.||Cytomegalovirus||Clay||Aluminum|
|Non-tuberculous||Propionibacterium||Endemic fungi||Epstein-Barr virus||Pine||Beryllium|
|Cell-wall deficient(L-forms)||acnes||Herpes simplex virus||Pollen||Zirconium|
Signs and Symptoms of ‘Sarcoidosis’ with Miasmatic Analysis
- Up to one-third are asymptomatic
- Acute presentation (Lofgren’s syndrome) with fever, malaise, arthralgia, erythema nodosum and uveitis
- Chronic presentation with fever, weight loss, dry cough or SOB
- Symptoms are usually mild if thoracic disease only
Rarer presentations include-
- Hypercalcaemia (renal stones, constipation and dehydration)
- Red eyes
- Skin rashes
- Central and peripheral nerve palsies
- Hypothalamic deficiency
- Bilateral salivary gland enlargement
- Cardiomyopathy or arrhythmias
|Sign or Symptom||Fundamental Miasm||Secondary/ Associated Miasm|
|General discomfort, uneasiness, or ill feeling (malaise)||Psora||Psora- Syphilis|
|Shortness of breath||Psora||Sycosis|
|Enlarged lymph glands (armpit lump)||Psora||Sycosis|
|Fatigue (one of the most common symptoms in children)||Psora||Syphilis|
|Weight loss (one of the most common symptoms in children)||Psora-Syphilis|
|Tearing, decreased||Psora||Sycosis, Syphilis|
|Nosebleed – symptom||Psora- Syphilis|
|Hair loss||Psora||Sycosis, Syphilis|
|Eye burning, itching, and discharge||Psora||Psora- Syphilis|
|Abnormal breath sounds (e.g. rales)||Psora- Syphilis||Sycosis|
Radiological features of Sarcoidosis
- May be normal.
- Stage 1 – bilateral hilar and mediastinal lymphadenopathy (particularly right paratracheal and aortopulmonary window nodes).
- Stage 2 – lymphadenopathy and parenchymal disease.
- Stage 3 – diffuse parenchyma disease only.
- Stage 4 – pulmonary fibrosis.
Egg shell calcification of both hila
‘1-2-3 sign’ – Posteroanterior (PA) chest radiograph of a 31-year-old woman with class I sarcoidosis shows right paratracheal (arrowheads) and bilateral hilar (arrows) lymphadenopathy. This pattern of lymphadenopathy is classic for sarcoidosis and is referred to as the 1-2-3 sign or Garland triad.
The parenchymal disease involves reticulonodular shadowing in a perihilar, mid zone distribution. There is bronchovascular and fissural nodularity. Rarely air space consolidation or parenchymal bands may also be present. Fibros is affects the upper zones where the hilar are pulled superiorly and posteriorly. Lymph nodes can demonstrate egg shell calcification.
Very good at confirming irregular septal, bronchovascular and fissural nodularity. Traction bronchiectasis, fibrosis and ground glass change may be present. There may also be tracheobronchial stenosis. Also may be seen subdiaphragmatic, cardiac, bone, hepatic and splenic involvement on the same scan.
CT shows precarinal lymphadenopathy with rim calcification (arrow). This pattern of calcification is referred to as eggshell calcification and is commonly seen with sarcoidosis
A: CT shows ill-defined nodules in a bronchovascular distribution (arrow) in the right upper lobe
B: CT with mediastinal windowing shows right hilar lymphadenopathy (arrow)
C: CT at the level of the inferior pulmonary veins shows left hilar lymphadenopathy (arrow)
D: CT at the level of the lower lobe pulmonary arteries shows subcarinal lymphadenopathy (arrow
HRCT. Irregular septal, bronchovascular and fissural nodularity
Radiological Differential diagnosis
- Infection – TB
- Lymphangitis carcinomatosis
- Chronic hypersensitivity pneumonitis
Clinical Staging of Sarcoidosis
|Stage 0||A normal chest radiograph|
|Stage I||Lymphadenopathy only|
|Stage II||Lymphadenopathy and lung parenchymal disease|
|Stage III||Parenchymal lung disease only|
|Stage IV||Pulmonary fibrosis|
Diagnosis of Sarcoidosis
- Histological evidence of granulomatous inflammation.
- The exclusion of the known causes of granulomatous inflammation other than sarcoidosis.
- Evidence of at least two separate organs involved with the disease.
Examinations and Tests for Sarcoidosis
- CBC, Chem-7 or Chem-20, ACE levels
- Chest x-ray to see if the lungs are involved or lymph nodes are enlarged and CT scan
- Biopsy of Lymph node, Skin lesion biopsy, lung, Liver, Kidney
- Bronchoscopy and PFT
- EKG to see if the heart is involved
Common Complications of Sarcoidosis
- Diffuse interstitial pulmonary fibrosis and / or Pulmonary hypertension
- Anterior uveitis and / or Glaucoma and blindness (rare)
- Cardiac arrhythmias
- Cranial or peripheral nerve palsies
- Kidney stones
- Organ failure, leading to the need for a transplant
Treatment of Sarcoidosis
Treatment of Sarcoidosis
Main Goals of treatment
The treatment depends on
|To improve how the organs affected by sarcoidosis work||Involvement of vital organs (e.g., lungs, eyes, heart, or brain)|
|To relieve symptoms||Severity of symptoms|
|To shrink the granulomas||Extent of affection of the organs.|
Sarcoidosis and Homoeopathy
In clinical study carried out at Homoeo Cure and Research Institute, Kashipur, a total 50 cases of Sarcoidosis were considered. The following results were observed in the research.