Key Difference – Sarcoidosis vs Tuberculosis
Sarcoidosis and Tuberculosis are two diseases between which a key difference can be identified. Sarcoidosis in a non-infectious immune-mediated disease with non-caseating granuloma formation whereas tuberculosis is an infectious disease caused by Mycobacterium tuberculosis accompanied with caseation necrosis. This is the key difference between Sarcoidosis and Tuberculosis. Through this article let us examine this difference further.
What is Sarcoidosis?
Sarcoidosis is an immune-mediated disease. It is characterized by granuloma formation is various tissues. Granuloma secretes various chemicals such as 25(OH)2vitamin D3, which causes increase calcium levels in the blood. Patients will get a variety of clinical manifestations such as lymph node enlargement, lung fibrosis, arthritis, skin manifestation, etc. Sometimes nervous system involvement can occur which is called neuro-sarcoidosis. This is a long-standing progressive illness with multisystem involvement. Diagnosis is based on the symptoms and signs supported with elevated angiotensin-converting enzyme (ACE) levels and calcium levels in the blood. CT scan will show features such as lymphadenopathy and lung involvement. If detected early can be controlled effectively with steroids that can control the overactive immune response. Alternatively, drugs that are most commonly used to treat cancer and suppress the immune system, such as methotrexate, azathioprine, and leflunomide, may be used.
What is Tuberculosis?
Tuberculosis is caused by a mycobacterium called Mycobacterium tuberculosis. Tuberculosis has two forms pulmonary and extrapulmonary. Pulmonary tuberculosis is characterized by cavitation of lungs and destruction of lung parenchyma. Tuberculosis is common among immunocompromised people such as drug addicts, diabetic patients. Typical symptoms are a chronic cough, hemoptysis or passing blood with sputum, evening pyrexia, night sweats, loss of appetite and significant loss of weight. Any system can get involved in tuberculosis and examples are TB meningitis, TB arthritis, etc. Diagnosis is by the microbiological confirmation of the TB bacilli in affected tissues. Different methods are used to diagnose TB including acid fast stain, culture, and polymerase chain reaction. X-ray and CT scan may be helpful in the diagnosis. Treatment is by anti-tuberculous therapy that include isoniazid, rifampicin, pyrazinamide, and ethambutol. There are different treatment regimens, and long-standing compliance is essential during the treatment period. TB can be effectively treated with currently available medicines. There other different medicines available to treat resistant TB. BCG vaccine is used for prevention of disseminated tuberculosis in children. It is given at birth to all children as an intradermal injection. Mantoux test is used to detect previous exposure to tuberculosis. It will be positive even with BCG vaccination. However, Mantoux test will be strongly positive in a TB patient, and it’s an important supportive investigation.
What is the difference between Sarcoidosis and Tuberculosis?
Characteristics of Sarcoidosis and Tuberculosis:
Tuberculosis is caused by Mycobacterium tuberculosis, and it’s an infectious disease.
Sarcoidosis is an immune medicated disease where no infective agent is involved.
Tuberculosis cases caseating granulomas.
Sarcoidosis causes non caseating granulomas.
A chronic cough and hemoptysis are prominent in pulmonary tuberculosis due to cavitation of lungs.
Difficulty in breathing is prominent in pulmonary sarcoidosis due to lung fibrosis and infiltrations.
TB is diagnosed by microbiological confirmation by acid fast stain, culture, and PCR.
Sarcoidosis is diagnosed by typical signs plus elevated angiotensin-converting enzyme (ACE) levels and calcium levels,
TB is treated with anti-tuberculous treatment.
Sarcoidosis is treated with steroids and other immune suppressants.Image Courtesy: 1. Tuberculosis Symptoms By Häggström, Mikael. “Medical gallery of Mikael Häggström 2014”. Wikiversity Journal of Medicine 1 (2). DOI:10.15347/wjm/2014.008. ISSN 20018762. [Public domain], via Wikimedia Commons 2. Sarcoidosis By NHLBI authors. [Public domain], via Wikimedia Commons