Sarcoidosis

Sarcoidosis Overview

Sarcoidosis is an inflammatory disease that affects multiple organs in the body, but mostly the lungs and lymph glands. In people with sarcoidosis, abnormal masses or nodules (called granulomas) consisting of inflamed tissues form in certain organs of the body. These granulomas may alter the normal structure and possibly the function of the affected organ(s).

What Are the Symptoms of Sarcoidosis?

The symptoms of sarcoidosis can vary greatly, depending on which organs are involved. Most patients initially complain of a persistent dry cough, fatigue, and shortness of breath. Other symptoms may include:

  • Tender reddish bumps or patches on the skin
  • Red and teary eyes or blurred vision
  • Swollen and painful joints
  • Enlarged and tender lymph glands in the neck, armpits, and groin
  • Enlarged lymph glands in the chest and around the lungs
  • Hoarse voice
  • Pain in the hands, feet, or other bony areas due to the formation of cysts (an abnormal sac-like growth) in bones
  • Kidney stone formation
  • Enlarged liver
  • Development of abnormal or missed heart beats (arrhythmias), inflammation of the covering of the heart (pericarditis), or heart failure
  • Nervous system effects, including hearing loss, meningitis, seizures, or psychiatric disorders (for example, dementia, depression, psychosis)

In some people, symptoms may begin suddenly and/or severely and subside in a short period of time. Others may have no outward symptoms at all even though organs are affected. Still others may have symptoms that appear slowly and subtly, but which last or recur over a long time span.

Who Gets Sarcoidosis?

Sarcoidosis most often occurs between 20 and 40 years of age, with women being diagnosed more frequently than men. The disease is 10 to 17 times more common in African-Americans than in Caucasians. People of Scandinavian, German, Irish, or Puerto Rican origin are also more prone to the disease. It is estimated that up to four in 10,000 people in the U.S. have sarcoidosis.

What Causes Sarcoidosis?

The exact cause of sarcoidosis is not known. It may be a type of autoimmune disease associated with an abnormal immune response, but what triggers this response is uncertain. How sarcoidosis spreads from one part of the body to another is still being studied.

How Is Sarcoidosis Diagnosed?

There is no single way to diagnose sarcoidosis, since all the symptoms and laboratory results can occur in other diseases. For this reason, your doctor will carefully review your medical history and examine you to determine if you have sarcoidosis. The main tools your doctor will use to diagnose sarcoidosis include:

  • Chest X-rays to look for cloudiness (pulmonary infiltrates) or swollen lymph nodes (lymphadenopathy)
  • HRCT scan (high resolution CT) to provide an even more detailed look at the lungs and lymph nodes than provided by a chest X-ray
  • Pulmonary function (breathing) tests to measure how well the lungs are working
  • Bronchoscopy to inspect the bronchial tubes and to extract a biopsy (a small tissue sample) to look for granulomas and to obtain material to rule out infection. Bronchoscopy involves passing a small tube (bronchoscope) down the trachea (windpipe) and into the bronchial tubes (airways) of the lungs

How Is Sarcoidosis Treated?

There is no cure for sarcoidosis, but the disease may get better on its own over time. Many people with sarcoidosis have mild symptoms and do not require any treatment. Treatment, when it is needed, is given to reduce symptoms and to maintain the proper working order of the affected organs.

Treatments generally fall into two categories — maintenance of good health practices and drug treatment. Good health practices include:

  • Getting regular check-ups with your health care provider
  • Eating a well-balanced diet with a variety of fresh fruits and vegetables
  • Drinking enough fluids every day
  • Getting six to eight hours of sleep each night
  • Exercising regularly and managing your weight
  • Quitting smoking

Drug treatments are used to relieve symptoms and reduce the inflammation of the affected tissues. The oral corticosteroid prednisone is the most commonly used treatment. Fatigue and persistent cough are usually improved with steroid treatment. If steroids are prescribed, you should see your doctor at regular intervals so that he or she can monitor the disease and the side effects of treatment. Other treatment options include methotrexate(Otrexup, Rheumatrex), hydroxychloroquine (Plaquenil), and other drugs.

What Can Happen As the Disease Progresses?

In many people with sarcoidosis, the disease appears briefly and then disappears without the person even knowing they have the disease. Twenty percent to 30% of people have some permanent lung damage. For a small number of people, sarcoidosis is a chronic condition. In some people, the disease may result in the deterioration of the affected organ. Rarely, sarcoidosis can be fatal. Death usually is the result of complications with the lungs, heart, or brain.​

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