Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Featured sarcoidosis patient discussions on experience with
disease
"I am a 51 yr old black woman and I have sarcoidosis. I was misdiagnosed
initially for 3 yrs. (1981 - 1984) my case was severe. At 24 yrs old I had
sarcoid in my bones (from head to toe), my skin, and nasal passages. I was
treated with prednisone for 20 years. At 24 yrs old, my joints were brittle and
had holes. Granulomas formed on my face and I have had 3 surgeries on my tear
ducts (both eyes). I happy to say my bones have rejuvenated, (medically
impossible), I have flawless skin, and I can breathe thru my nose. I have been
off prednisone to for 3 yrs. I’m now a beauty consultant and I feel good!
"I am a 52 year-old male. I have extreme shortness of breath on exertion,
constant fatigue, night sweats, skin lesions, etc. I was diagnosed with
sarcoidosis in 1998 after two years of tests, X-rays, CT scans, lymph node
biopsies, you name it. I finally found a specialist who was able to figure out
what was going on. He put me on Advair, prednisone, and an Albuterol inhaler.
The prednisone went from declining dose regimens to a constant 25 mg per day to
control my lung and skin lesions. After two years of this, I developed steroid
diabetes and gained a lot of weight. He suggested the Cleveland Clinic
Sarcoidosis Center. They now have me off the prednisone. I am now taking
methotrexate, which seems to be controlling the disease."
"I am have been suffering from sarcoidosis for the past 6 years that I know
of. It was discovered from a skin lesion, which I originally thought was a
severe case of acne. I visited a dermatologist and was diagnosed with this
dreaded disease. Since then I have encountered arthritic pain in most all my
joints. I have broken two fingers and an elbow bone ( how do you break an elbow
bone? -I don't know but I did) while working as a utility worker: All of which
are directly related to the sarcoid. Currently, I am taking 5 prescription
medications for the disease. My Bones are deteriorating, rapidly it would seem,
and I am only 42 years old. If there any remedies that anyone is aware of, I
would be very interested in knowing about them. "
Patient Discussions are not a substitute
for professional medical advice, or treatment.
See the disclaimer at the
bottom of the comments page.
What is sarcoidosis?
Sarcoidosis is a disease that results from a specific type of inflammation of
tissues of the body. It can appear in almost any body organ, but it starts most
often in
the lungs or lymph nodes.
The cause of sarcoidosis is unknown. The disease can
appear suddenly and disappear. Or it can develop gradually and go on
to produce symptoms that come and go, sometimes for a lifetime.
As sarcoidosis progresses, microscopic lumps of a specific form of inflammation, called granulomas, appear in the affected tissues. In the majority of cases, these granulomas
clear up, either with or without treatment. In the few cases where the
granulomas do not heal and disappear, the tissues tend to remain inflamed and
become scarred (fibrotic).
Sarcoidosis was first identified over 100 years ago by
two dermatologists working independently, Dr. Jonathan Hutchinson in England and
Dr. Caesar Boeck in Norway. Sarcoidosis was originally called Hutchinson's
disease or Boeck's disease. Dr. Boeck went on to fashion today's name for the
disease from the Greek words "sark" and "oid," meaning flesh-like. The term
describes the skin eruptions that
are frequently caused by the illness.
What are symptoms of sarcoidosis?
Shortness of breath (dyspnea) and a cough that won't go
away can be among the first symptoms of sarcoidosis. But sarcoidosis can also
show up suddenly with the appearance of skin rashes. Red bumps
(erythema nodosum) on
the face, arms, or shins and inflammation of the eyes are
also common symptoms.
It is not unusual, however, for sarcoidosis symptoms to be
more general. Weight loss, fatigue, night sweats, fever, or just an
overall feeling of ill health can also be clues to the disease.
Lymph nodes help the body's immune system fight infections. Causes of swollen lymph nodes (glands) may include infection (viral, bacterial, fungal, parasites). Symptoms of swollen lymph nodes vary greatly. They can sometimes be tender, painful or disfiguring. The treatment of swollen lymph nodes depends upon the cause.
Low testosterone can affect both men and women. Causes of low testosterone in males include undescended testicles and injury to the scrotum. Low testosterone in females includes ovary conditions. Treatment for low testosterone in men includes testosterone replacement therapy. Currently there is no FDA approved testosterone treatment for women.
Carpal tunnel syndrome is a condition in which irritation of the wrist's median nerve causes tingling and numbness of the thumb, index, and the middle fingers. This condition is known as tarsal tunnel syndrome in the ankles and feet. Treatment of carpal tunnel syndrome depends on the severity of the symptoms and the nature of any disease that might be causing the symptoms.
Pulmonary fibrosis is scarring throughout the lungs. Pulmonary fibrosis can be caused by many conditions including chronic inflammatory processes, infections, environmental agents, exposure to ionizing radiation, chronic conditions, and certain medications. Symptoms include shortness of breath, coughing, and diminished exercise tolerance. Treatment options are dependent on the type of pulmonary fibrosis; lung transplant and/or medications are optons.
Eye floaters are deposits or condensation that forms in the eye's vitreous humor. These deposits cast shadows on the retina, and as the eye moves, the deposits shift position, making it appear as though the shadows are moving or floating.
Pulmonary hypertension is an abnormal elevation of the pressure in the pulmonary circulation caused by the constriction of the blood vessels that supply blood to the lungs. Shortness of breath and dizziness are symptoms of pulmonary hypertension. Treatment involves diuretics, blood thinners, calcium channel blockers, and using supplemental oxygen to increase blood oxygen levels.
Erythema nodosum is a skin inflammation that results in reddish, painful, tender lumps most commonly located in the front of the legs below the knees. Erythema nodosum can resolve on its own in 3 to 6 weeks, leaving a bruised area. Treatments include anti-inflammatory medications and cortisone by mouth or injection.
Pericarditis is the inflammation of the pericardial sac that surrounds the heart. The causes of pericarditis include injury from heart attack, heart surgery, trauma; viral or fungal infection, HIV, tumors, mixed connective tissue disease, metabolic disease, medication reactions, or idiopathic. Treatment for pericarditis is generally medication, however, sometimes surgery is necessary.
Interstitial lung disease, is a term to describe a certain lung condition. Causes of interstitial lung disease include lung infection, exposure to toxins in the environment (asbestos for example), medications (chemotherapy), radiation therapy, and chronic autoimmune disorders. Common symptoms of interstitial lung disease include a dry cough and shortness of breath. Diagnosis and treatment depend upon the cause of the condition.
Optic neuritis is inflammation of the optic nerve, the structure that connects the eye to the brain. The precise cause of optic neuritis is unknown, but it is thought to be a type of autoimmune disorder. Optic neuritis most commonly develops due to an autoimmune disorder that may be triggered by a viral infection.
Myocarditis is an inflammation of the heart muscle and can be caused by a variety of infections, conditions, and viruses. Symptoms of myocarditis include chest pain, shortness of breath, fatigue, and fluid accumulation in the lungs. Treatment mainly involves preventing heart failure with medication and diet, as well as monitoring for heart rhythm abnormalities.
Sudden cardiac arrest is an unexpected, sudden death caused by sudden cardiac arrest (loss of heart function). Causes and risk factors of sudden cardiac arrest include (not inclusive): abnormal heart rhythms (arrhythmias), previous heart attack, coronary artery disease, smoking, high cholesterol, Wolff-Parkinson-White Syndrome, ventricular tachycardia or ventricular fibrillation after a heart attack, congenital heart defects, history of fainting, and heart failure, obesity, diabetes, and drug abuse. Treatment of sudden cardiac arrest is an emergency, and action must be taken immediately.
Brain lesions (lesions on the brain) are caused by trauma, inflammation, autoimmune diseases, cancers, other diseases, stroke, bleeding, pituitary adenomas, and cerebral palsy. Symptoms of brain lesions include headache, nausea, fever, neck pain and stiffness, affected vision and speech, weakness or paralysis to one side of the body. Diagnosis of brain lesions is generally with imaging studies like CT or MRI scans. Treatment and prognosis of brain lesions depends on the cause of the lesion.
Iritis is inflammation of the iris, the colored portion of the eye. Symptoms include a red, painful eye, blurry vision, and light sensitivity. Treatment usually involves cortisone eyedrops.
Superior vena cava syndrome is compression of the superior vena cava vein located in the upper chest. Causes of superior vena cava include lung cancer, lymphoma, other cancers in the chest, blood clots in the superior vena cava, or infection. Symptoms of the syndrome include shortness of breath. Superior vena cava syndrome is diagnosed by ultrasound, chest x-ray, CT scan, and in some cases biopsy. Treatment depends upon the cause of the syndrome.
The human body has two major sets of blood vessels that distribute blood from
the heart to the body. One set pumps blood from the right heart to the
lungs and
the other from the left heart to the rest of the body.
The portion of the circulation that
distributes oxygen-rich blood from the left side of the heart, throughout the
body, is referred to as the systemic circulation.
The blood then returns from
the body to the right side of the heart and passes through the lungs to
replenish oxygen.
It then returns to the left
side of the heart for another round through the systemic circulation.
The
portion of the circulation that distributes the blood from the right side of the
heart to the lungs is referred to as the pulmonary (lung) circulation.
The
pulmonary arteries are the major blood vessels that carry blood from the rig...
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