July 1, 2010
School of Medicine, Kochi
Dr. Malini Eapen’s work received appreciation when she won the best poster award at the recently concluded CME of Indian Association of Pathologists and Microbiologists.
Dr. Malini’s poster titled An Enigma or Should We Say Sarcoi’dama highlighted sarcoidosis, a disease of unknown cause that leads to inflammation.
“Sarcoidosis is a multisystem disorder with unknown etiology but protean manifestations,” stated Dr. Malini’s poster. “It occurs in all races with different incidence probably due to lack of screening programs and the overshadowing presence of tuberculosis.”
The poster presented a detailed case-study of a 47-year old man.
“The gentleman complained of general weakness. He was a known case of chronic renal disease and was operated for bilateral renal calculi five years ago. His physical examination was normal.”
“A bone marrow study was undertaken that showed non-caseating granulomatous inflammation. A combination of clinical, biochemical and histopathologic findings prompted a diagnosis of sarcoidosis.”
The immune system defends the body by releasing certain chemicals to fight harmful substances. During this process, inflammation may occur. Once the harmful substance is destroyed, the inflammation goes away.
In the case of those who have sarcoidosis, however, the inflammation doesn’t subside. Immune system cells cluster together to form lumps called granulomas. Historically all granulomas were thought to be caused by tuberculosis. But that understanding is now slowly changing.
“Sarcoidosis is emerging from obscurity,” informed Dr. Malini. “Doctors are beginning to search for the needle of sarcoidosis in the haystack of tuberculosis. In our study, we utilized patient data at Amrita from November 2008 to January 2010.”
“We took granulomas diagnosed from marrow biopsy, segregated them as per identifiable cause and found that 43% of granulomas in marrow were due to sarcoidosis. The diagnosis was established in correlation with clinical, biochemical and histologic findings.”
“Case reports show that sarcoidosis is predominant in males aged over forty. Most are symptomatic at presentation with pulmonary manifestations taking a front seat.” Learn More »
The poster eloquently summed up a take-home message.
“Sarcoidosis is not rare. Not every granuloma is tuberculosis.”
“It is important to keep this in mind especially when patients come with pulmonary symptoms,” stated Dr. Malini.
Currently Associate Professor in the Department of Pathology at the School of Medicine, Dr. Malini joined Amrita nearly one year ago. She has been instrumental in maintaining the hematopathology lab as per NABL standards.
We congratulate her on her achievement.