Grammy award-winning rapper Krayzie Bone was rushed to hospital last week after coughing up blood and is now fighting for his life on a ventilator.
The rapper, famous for being one-fifth of hip-hop group Bone Thugs -n-Harmony, underwent a chest X-ray which revealed a leak from an artery in his lung, believed to stem from his long battle with a condition called sarcoidosis.
Sarcoidosis is an immune system disorder that can affect any organ, but most commonly affects the lungs and lymph nodes.
It causes the immune system to overreact to a former invader, building up clumps of immune cells that lodge in the body’s tissues and cause inflammation.
The clumps of immune cells known as granulomas can heal on their own, but they can also lead to scarring of lung tissue that becomes stiff and inflamed, increasing the risk of long-term breathing problems and strain on the heart.
Below, DailyMail.com answers questions about sarcoidosis, how it damages the lungs and what might cause it.
Details: Bone Thugs-n-Harmony artist Krayzie Bone, 50, was hospitalized in Los Angeles on Friday after coughing up blood, sources told AllHipHop
Sarcoidosis often causes no symptoms and goes away on its own. But if the disease progresses without treatment, it can lead to permanent scarring of the lung tissue, causing the blood vessels responsible for transporting blood from the heart to the lungs to harden.
What is sarcoidosis?
Granuloma can affect any organ system in the body, but in Mr. Henderson’s case, it affected his lungs.
The bleeding into the air sacs in one of his lungs, which can cause a patient to cough up blood, is likely the result of diffuse alveolar hemorrhage, a rare but potentially life-threatening complication.
Mr Henderson underwent emergency surgery to repair the leaking artery, but the bleeding continued. Mr Henderson is now sedated and on a ventilator.
Sarcoidosis is considered rare, with fewer than 200,000 cases in the US at any time, according to the Food and Drug Administration. It’s the same disease that killed comedian Bernie Mac in 2008.
Although not an autoimmune disease, the condition does cause an aggressive immune response to an unknown trigger, usually an infection or environmental pollutant.
The immune response involves a build-up of specific immune cells called T cells. Together with another type of cells called macrophages, they form the granulomas in lung tissue. Over time, the tissue becomes inflamed and the scar tissue hardens.
That buildup of scar tissue can lead to the narrowing of the blood vessels that should have the same normal blood flow pressure, a complication known as pulmonary hypertension.
This puts pressure on the right side of the heart, which then has to work overtime to pump blood to the lungs, making it harder to breathe. It also leads to severe fatigue in 70 percent of patients.
What are the symptoms?
Most people with sarcoidosis won’t even know it. However, between 40 and 70 percent of patients will experience symptoms.
In almost 70 percent of cases, patients have a dry cough that doesn’t go away, while about a third have trouble breathing, and more than a fifth experience chest pain.
Mr Henderson first went to hospital on Friday after coughing up blood. Although the details of his medical condition have not been made public, this symptom could indicate that small air sacs in his lungs have filled with blood, a life-threatening syndrome called diffuse alveolar hemorrhage.
His diagnosis of sarcoidosis was revealed in 2016 when he revealed he was suffering from an ‘intense case of pneumonia’ as the drugs weakened his immune system. The pneumonia forced him to cancel tour dates in Canada.
In addition to causing symptoms similar to those of a common respiratory infection, sarcoidosis can cause joint and bone pain, swollen lymph nodes, unexplained weight loss, kidney stones, and night sweats.
How serious is it?
Most people with sarcoidosis who have had the disease for three years or more are likely to have a chronic disease, which leads to permanent damage to the organs in 10 to 20 percent of cases.
Only about five percent of sarcoidosis patients die, but those who do often experience bleeding from lung tissue, lung scarring, and heart failure if the specific case involves disruptions to the heart’s electrical system.
High blood pressure in the pulmonary arteries, or pulmonary hypertension, is a potentially serious complication.
The arteries are a type of blood vessel that transports blood from the heart to the lungs for oxygenation, meaning it mainly affects the right side of the heart.
When Mr. Henderson went to the hospital, doctors identified the leak and immediately took him to the operating room to surgically close the break in the artery that caused the bleeding.
Doctors performed the operation, which involved suturing the hole in the artery or placing a plaster over it, but it did not stop the bleeding.
Although the severity of Mr. Henderson’s condition is still unknown, he is currently unconscious and connected to a ventilator.
What causes it?
The exact cause of pulmonary sarcoidosis is unknown, but scientists believe that an external pathogen such as a virus or environmental pollutants such as chemicals in the air may cause the disease.
There is also evidence of a genetic basis. Having at least one first-degree relative with sarcoidosis was associated with a 3.7-fold increase in the risk of sarcoidosis, according to a study in the European Respiratory Journal.
In addition to there being more than one possible cause, there are several factors that increase a person’s risk of developing sarcoidosis.
Among African Americans, the most affected group in the US, the estimated lifetime risk of developing sarcoidosis could be as high as 2 percent.
Counterintuitively, some studies have found that the risk of sarcoidosis due to smoking is reduced. A 2016 study in the journal Respiratory Medicine found that people who currently smoke had a lower risk of developing sarcoidosis compared to those who had never smoked.
Doctors at the Mayo Clinic in Minnesota conducted a study of 345 people with sarcoidosis and 345 healthy people.
The risk of developing sarcoidosis was about 66 percent lower for current smokers than for people who had never smoked. And even considering both never-smokers and ex-smokers together, current smokers had a 62 percent lower risk of sarcoidosis.
Still, the extent to which smoking affects the risk of being diagnosed with sarcoidosis depends on each individual patient. A study in the journal Scientific Reports shows that the way genetics and smoking interact can influence whether a person develops sarcoidosis.
That finding suggested that genetics or smoking alone do not determine whether someone develops sarcoidosis. On the contrary, both factors together determine the risk.
How is the diagnosis made?
Imaging tests such as X-rays and CT scans are the most common ways to diagnose someone with sarcoidosis.
In Mr. Henderson’s case, doctors ordered a CT scan, which uses computers and rotating X-ray machines to get a detailed view of specific parts of the body.
Doctors will also likely perform noninvasive tests that measure lung function, blood and urine tests to show how well other organs are working, and an electrocardiogram to check the heart’s electrical activity.
How is it treated?
The treatment of sarcoidosis is primarily aimed at preventing organ damage and reducing inflammation. This often requires patients to take immune-suppressing medications.
Corticosteroids reduce lung inflammation by suppressing the immune system and blocking the body’s production of substances such as cytokines that are known to inflame tissue.