Oldest Described Case Of Sarcoidosis

Robespierre

A condition called sarcoidosis causes small masses of cells called granulomas to form, usually in the eyes, on the skin, or in the lymph nodes, as well as affecting the lungs. In around 80 percent of cases, sarcoidosis goes away on its own, but the remaining instances can be quite serious, and it’s not always easy for professionals to tell the difference—both kinds have the same initial symptoms of wheezing, dry cough, chest pain, and shortness of breath. However, if chronic sarcoidosis isn’t treated, it can lead to trouble breathing, blindness, central nervous system disorders, facial paralysis, kidney failure, or even heart failure.

Another danger of untreated sarcoidosis is an elevated risk of bone fracture. A study of both men and women with sarcoidosis showed normal bone density (after adjusting for age), but a higher than usual incidence of fracture due to fragility. The suggested explanation for this is that patients who have sarcoidosis may have difficulty absorbing or using calcium. Fewer than 10 percent of sarcoidosis patients are found at autopsy to have the condition in the gastrointestinal tract, and fewer than one percent of living patients show symptoms there, but calcium metabolism is known to be effected.

The study was done by French scientists, and France is also the source of what medical historians suggest may be the oldest described case of sarcoidosis. Joining comedian Bernie Mac, boxer Evander Holyfield and actress Karen Duffy as a celebrity with sarcoidosis is the lawyer and revolutionary Maximilien de Robespierre, who was guillotined in 1794. Contemporaries described him as "riddled with maladies," and his symptoms, including poor vision, frequent nosebleeds, fatigue, skin disease on his face, and jaundice are all consistent with sarcoidosis.

Robespierre’s treatment plan apparently involved oranges, bathing and bloodletting. Modern treatment is a little different, and no bloodletting is involved. In fact, if the disease seems not to be threatening vital organs, patients may need little more than rest and a healthy diet, including oranges. When measures need to be taken to combat organ failure, the most common approach uses anti-inflammatory medications, such as corticosteroids.

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