Efficacy of Homoeopathy

in Treatment of

Sarcoidosis
An Evidence Based Report

Dr. Rajneesh Kumar Sharma MD (Hom) Dr. Ruchi Rajput BHMS

2011

Efficacy of Homoeopathy in Treatment of Sarcoidosis

(An evidence based Report)
Dr. Rajneesh Kumar Sharma MD (Homoeopathy) Dr. (Km) Ruchi Rajput BHMS

Homoeo Cure Research Centre P. Ltd. NH 74- Moradabad Road Kashipur (UTTARANCHAL) - INDIA Ph- 09897618594 E. mail- [email protected]

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 evidence based report on treatment of Sarcoidosis with Homoeopathy.

Introduction
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 unrecognised 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 till now. 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 mentals 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 maximum role in altering the physiology 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 2040 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
Mycobacteri a Bacteria Fungi Viruses Dusts Clay/ Talc Pine Pollen Metals Aluminum Beryllium Zirconium Tuberculous Corynebacteriu Cryptococcus Cytomegalov m spp. spp. irus NonPropionibacteri tuberculous um acnes Cell-wall deficient (L-forms) Tropheryma whippleii Endemic fungi Epstein-Barr virus Herpes simplex virus

Mixed

Signs and Symptoms of Sarcoidosis with Miasmatic Analysis

Up to one-third are asymptomatic Acute presentation (Lofgrens syndrome) with fever, malaise, arthralgia, erythema nodosum and uveitis Chronic presentation with fever, weight loss, dry cough or SOB (Shortness of Breath) 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

Radiological features of Sarcoidosis

CXR 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.

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. Fibrosis affects the upper zones where the hilar are pulled superiorly and posteriorly. Lymph nodes can demonstrate egg shell calcification.

HRCT
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.

Radiological Differential diagnosis

Lymphoma Infection TB Lymphangitis carcinomatosis Chronic hypersensitivity pneumonitis

Clinical Staging of Sarcoidosis

Stage 0 Stage I Stage II Stage III Stage IV A normal chest radiograph Lymphadenopathy only Lymphadenopathy and lung parenchymal disease Parenchymal lung disease only 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 the organs Involvement of vital affected by sarcoidosis organs (e.g., lungs, eyes, heart, or brain) To relieve symptoms To shrink the granulomas Severity of symptoms Extent of affection of the organs.

Sarcoidosis and Homoeopathy

In clinical study carried out at Homoeo Cure and Research Institute, Kashipur (Uttaranchal), total 96 cases of Sarcoidosis were registered during the period between 2007-2011. The data of only 33 patients has been studied here. The following results were observed in the research.

Discussion
Sarcoidosis was found more prevalent in married patients (82%) than single ones (18%). Sarcoidosis was found in moderate built individuals (46%), obese (27%), thin (27%). The prevalence of Sarcoidosis was mostly in working patients (46%), house wives (27%), Students (18%) and non working ones (09%). The most frequent was with pulmonary manifestations (55%), arthritis knee (37%), , skin lesions (9%), uveitis (9%), with Cardiac (9%), with Neuorological (9%) and with Nephrological manifestations (9%).

The most frequent miasm was found to be Sycosis (37%). Others being Psora (36%), Psora- Sycosis combination (0%), Pseudopsora (27%), Syphilis and Cancerous nil. Out of 33 cases of Sarcoidosis, Cure-rate was 27%, Relieved- 73% and Not Cured- 0%. The highiest percentage of cure was in Sycosis (36%) with 50% relieved, Pseudopsora (27%) with 67% relieved, Psora (37%) with 100% relieved. Cure rates of the indicated remedies in this study were Ars iod-100%, Lycopodium- 50%, Pulsatilla16.6%, Rhus tox- 33%, Tuberculinum- 100%. While all other remedies relieved all cases.

Conclusion
The above study confirms the efficacy of Homoeopathy in treatment of Sarcoidosis in all stages and all types, with amazing success when applied as per laws of similia and proves its superiority among all the existing streams of treatment.

Case History -1 R. No.- 13196, DOR- 02-09-2007, Name- GS G, Male- 24 Years, Unmarried, Sikh, OccupationStudent, Built- Thin, Income Group- Average, Diagnosis- Sarcoidosis Stage 3 with Pulmonary manifestations, Prominent Miasm- Sycosis, Result- Cured. Clinical picture- Low Grade Fever worse evening, Loose motions off and on, Nausea, Vomiting off and on, Thirst- Normal, AppetiteNormal, Stool- Frequent- normally formed stool, Urine- Normal, Perspiration- Normal, MentalsSuspicious, Irritable, loathing of life, Desire- salt, Aversion- Fats, Sleep- Normal. Alopecia.

Case Histories

Past History- Malaria- Plasmodium vivex, recurrent pneumonia in childhood. Family History- Mother Tubercular. Investigations- SGPT- 62, ACE (04-112007)- 122 (Normal- 08- 52 U/L), MxNegative, TB Elisa- Equivocal, CT Thorax (0211-2007)- Mediastinal Lymphadenopathy. Bilateral Hilar Lymphadenopathy. Increased ACE- Negative Mx- CT Findings positive for lymphadenitis = Sarcoidosis

Homoeopathic TreatmentFirst prescription- 05-09-2007 Ars. iodatum 200 weekly, Sac lac TDS Second Prescription- 09-11-2007 Much better. Tenesmus, Dysentry, Aphthous ulcers in mouth with much salivation. Merc sol. 30 TDS

Third Prescription-21-12-2007 Much Better. CT- Single Subcarinal Lymphnode. Other nodes dissolved. ACE- 99.9 U/L CST Fourth Prescription- 05-03-2008 Almost asymptomatic, cheerful. ACE- 58.8 U/L (Normal Range- 08- 52 U/L) CST Result Complete cure of Sarcoidosis with Homoeopathy.

Case History -2 R. No.- 13672, DOR- 22-07-2008, Name- K M, Female- 18 Years, Unmarried, Hindu, Occupation- Student, Built- Thin, Income Group- Poor, Diagnosis- Sarcoidosis Stage 2 with Pulmonary manifestations, Prominent Miasm- Pseudopsora, Result- Cured. Clinical picture- Low Grade Fever worse morning, constipation, hard dry stool in three days, without urging, Thirst- Normal, AppetiteGood, Urine- Normal, Perspiration- Excessive < nights < sleep during, Mentals- Suspicious, Irritable, loathing of life, Desire- salt, Aversionsweets, Sleep- Normal, swelling of cervical, inguinal and mesenteric lymph nodes, indurated nodules in skin, general emaciation and weakness.

Past History- Typhoid. Family History- Father Diabetic, brother tubercular. Investigations- TFT WNL, ACE (25-07-2008)80 (Normal- 08- 65 U/L), Mx- Negative. CT Abdomen and Thorax (13-12-2007) Multiple enlarged centrally necrotic descrete as well as conglomerate peripherally enhancing nodes in bilateral paraaortic, precaval, peripancreatic, portal region, left prevascular space, left hilar and right paratracheal region with formation of centrally caseating peripherally enhancing lesion in peripancreatic region. Increased ACE- Negative Mx- CT Findings positive for lymphadenitis = Sarcoidosis

Homoeopathic TreatmentFirst prescription- 10-07-2008 Tuberculinum 1m Stat, Ars. iodatum 30 TDS Second Prescription- 11-08-2008 Condition same. Appetite good with emaciation and Lns. US Abdomen (22-07-2008)Peripancreatic, paraaortic with paracaval Lymphadenopathy. ACE (25-07-2008) 80 (865U/L). Iodium. 30 TDS Third Prescription-12-09-2008 Little Better. CST

Fourth Prescription- 09-10-2008 Almost asymptomatic. CST Fifth Prescription- 11-01-2009 Almost asymptomatic. CST Sixth Prescription- 29-01-2009 USG- Normal, No Lymph nodes. ACE- 39.51 U/L (Normal Range- 08- 65 U/L). CST. Result Complete cure of Sarcoidosis with Homoeopathy.

Case history 3 R. No.- 14136, DOR- 22-06-2009, Name- S P, Female- 56 Years, Married, Hindu, OccupationHouse wife, Built- Obese, Income Group- Middle class, Diagnosis- Sarcoidosis with uveitis, arthritis with pulmonary manifestations, Prominent Miasm- Sycosis, Result- Cured. Clinical pictureComplaints started with uveitis 10 years ago. Tinnitus, ringing in ears < nights, dry eyes, Burning pains with numbness with varicose veins in both lower limbs. HTN. Extremely sensitive temperament. Loose stools twice or thrice a day for two years. Hot patient.

Past HistoryRheumatic fever at 12 years of age. Family HistoryNot marked. InvestigationsPFT moderately restricted pattern. ACE- 107.3 (27-05-2009). Chest x ray- (13-09-2008) Normal. CT thorax- 25-08-2005- mediastinal and hilar lympharenopathy. BP- 150/90. SPO2- 99%. TLC- 12650, ESR- 30.

Homoeopathic TreatmentFirst prescription- 22-09-2009 Pulsatilla 200 Stat, SL TDS Second Prescription- 09-10-2009 Pains better. Cough and eye complaints <. Beryllium met 30 TDS Third Prescription-05-02-2010 Much Better. Almost asymptomatic. ACE Normal. ACE- 20-01-2010 ---- 19 U/L (Normal Range- 0865 U/L). CST. Result Complete cure of Sarcoidosis with Homoeopathy.

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Dr. Rajneesh Dr. Ruchi