Sarcoidosis less serious than lupus

Dear Dr. Gott: Please explain the difference between sarcoidosis and lupus, as well as the symptoms of each.

Dear Reader: Sarcoidosis, a disease of unknown cause, is marked by low-grade areas of inflammation in many of the body’s organs, chiefly the lungs, lymph glands and liver. Symptoms may be absent or minimal. Swollen glands are common and a rash may be present, but the disorder is often diagnosed by accident during routine chest X-ray examinations. The diagnosis is confirmed by biopsy. Treatment is rarely required.

In contrast, lupus is a potentially fatal autoimmune disease. It causes rash, pleurisy, swollen glands, arthritis and kidney damage. It is diagnosed by blood tests. Steroid therapy may be required to prevent renal failure.

Experts consider the two disorders to be unrelated.

To give you related information, I am sending you a copy of my Health Report “Lupus: The Great Imitator.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dear Dr. Gott: Is it true that eating bread will cure arthritis?

Dear Reader: Not to my knowledge.

Arthritis can be caused by inflammation or age-related wearing down of the joints; both conditions are best treated with appropriate medication.

Dear Dr. Gott: Please devote a column to Parkinson’s disease. I’m a 77-year-old male in good health. Several months ago I developed an intermittent tremor in my left hand that intensifies when I’m under stress. My doctor indicates this might be Parkinson’s, but isn’t too concerned.

Dear Reader: Parkinson’s disease, a common neurological disorder that leads to shaking at rest, a shuffling gait, an immobile face and other symptoms, is caused by a depletion of a brain chemical called dopamine. The reason for this is not known.

Parkinson’s disease is usually progressive. In the early stages, no treatment is necessary, but as the tremor and other manifestations become more prominent, drug therapy (with Sinemet or other medicines) is advisable. The diagnosis is made by the patient’s “clinical appearance” (how he or she looks, talks and walks). Patients with Parkinson’s disease should, in my opinion, be under the care of neurologists.

You may have this disease – or you could have another condition, such as benign familial tremor, an inherited shakiness that is not a hazard to health. Therefore, I suggest that you ask your doctor to refer you to a neurologist, who – after examining you – will confirm (or reject) the diagnosis and advise you whether treatment is necessary at this stage.