Doctor explains concerns of cluster of pulmonary disease By Sarah Riley News-Chronicle About 100 people gathered Thursday night at Aurora BayCare Medical center to hear about two pulmonary diseases that seem to have higher-than-normal occurrences in Northeast Wisconsin. Dr. Raul Menzoda-Ayala, a pulmonologist, said he is trying to educate the public about sarcoidosis, a disease he has treated in about 40 patients from the area. He also discussed primary pulmonary hypertension. He wanted to bring them together to start a support group and so legislators could hear about the disease in case state support might be needed to research its occurrence. "There must be something going on. I eventually had to do something," he said about Thursday's forum. Mendoza-Ayala said the cause of sarcoidosis is unknown, but that certain areas of the country tend to have clusters of patients. For example, the disease also is seen in the mining areas of Pennsylvania. "There must be something in our environment and in our genes that's causing this response," he said. Sarciodosis causes white blood cells involved with the immune system to head to the lungs even when there are no specific triggers. The cells occur in a recognizable pattern and the disease can cause inflammation of the lungs and swollen lymph nodes. It is typically first diagnosed in people ages 20-40 and 90 percent of them do well without treatment. The disease is common in Scandinavian countries, Mendoza-Ayala said, and many Northeast Wisconsin residents have ancestors from that part of the world. Another theory of its cause is exposure to beryllium. People who work in aircraft manufacturing are often exposed to the substance, as well as those who work with certain ceramics. Coming in contact with those products won't cause beryllium exposure, but manufacturing them might. Beryllium exposure is rare, he added. "Soil in Wisconsin may have more concentration of beryllium than in other areas of the country," he said, reminding the group that the idea was just a theory. Sarcoidosis can come on suddenly with symptoms of fever and a cough. Mendoza-Ayala said he likes to see patients with that type of the disease because it typically goes away on its own. "Take a couple of Tylenol and call me in the morning," he said about what he tells patients. The more persistent form of the disease can come on slowly with symptoms that resemble other diseases. It can cause complications, like headaches, seizures, sinus problems, kidney stones and liver problems. There are several medication options for sarciodosis patients. Pulmonary hypertension is a narrowing of the arteries between the heart and the lungs and can cause fatigue and shortness of breath in patients. The heart has to pump harder to get blood flowing, which can cause it to enlarge. "This is a condition that starts little by little," he said. "Most of the time when we diagnosis it it is too late." The disease resembles emphysema and occurs more often in middle-aged women. Chest pain, shortness of breath, fatigue, heart palpitations and fainting are symptoms. It can be treated with oxygen, blood thinners and vascular dilators.