Sarcoidosis

Sarcoidosis is a disease that leads to inflammation of the lymph nodes, lungs, liver, eyes, skin, or other tissues.

Sarcoidosis can affect almost any organ of the body. It most commonly affects the lungs.

Patients with sarcoidosis may not exhibit any symptoms. The signs and symptoms of sarcoidosis vary depending on which organs are affected. Signs and symptoms also may vary depending on your gender, age, and ethnic background.

The cause of sarcoidosis is not known. However, there may be more than one factor that may play a role in causing sarcoidosis.

There is not a cure for sarcoidosis, but several steps can be taken to manage the disease.

Sarcoidosis symptoms will often get better without any treatment. If treatment is needed, there are several medications which can be given to help manage certain symptoms.

Eat a healthy diet and remaining physically active are important when living with sarcoidosis.

Patients with sarcoidosis may not exhibit any symptoms.

The signs and symptoms of sarcoidosis vary depending on which organs are affected. Signs and symptoms also may vary depending on your gender, age, and ethnic background.

• Chest pain
• Dry cough
• Shortness of breath
• Wheezing
• Fatigue
• Fever
• Bone and Joint pain
• Loss of weight
• Loss of hair
• Rash
• Scars that become raised or inflamed
• Lumps on the skin or discolored skin (tend to appear on your back, arms, legs, and scalp. Sometimes they appear near the nose or eyes)
• Lupus pernio. (Disfiguring skin sores that may affect the nose, nasal passages, cheeks, ears, eyelids, and fingers)
• Headache
• Seizures
• Weakness on one side of the face
• Eye Burning
• Eye discharge
• Dry eyes
• Itchy eyes
• Eye pain
• Vision loss
• Depression
• Night sweats
• Anemia
• Swollen lymph nodes

Lofgren's syndrome is a classic set of signs and symptoms that occur in some people when they first have sarcoidosis. Signs and symptoms may include:

• Fever. Occurs in some people.
• Enlarged lymph nodes (which can be seen on a chest x ray).
• Arthritis, usually in the ankles. This symptom is more common in men than women.
• Erythema nodosum. This is a rash of red or reddish-purple bumps on your ankles and shins. The rash may be warm and tender to the touch. This symptom is more common in women than men.

The cause of sarcoidosis is not known. However, there may be more than one factor that may play a role in causing sarcoidosis.

Some researchers believe sarcoidosis develops if your immune system responds to certain triggers such as bacteria, viruses, dust, or chemicals.

Others believe genes may play in role in developing sarcoidosis.

Risk factors may include:

• Ethnic background. Sarcoidosis is more common in African-Americans and Caucasians of Scandinavian heritage.
• Gender. More women than men have sarcoidosis.
• Age. Sarcoidosis often begins between ages 20 and 40. Sarcoidosis is rare in young children.
• Genetic. A person with a close blood relative who has sarcoidosis is nearly five times as likely to develop the condition.

Sarcoidosis can be diagnosed based on a medical history, physical exam, as well as certain diagnostic tests.

Medical History:

Your doctor will ask you questions regarding your family history as well as questions regarding your possible exposure to certain triggers that may cause the development of sarcoidosis and/or to rule out other possible causes for your symptoms.

Physical Exam:

Your doctor will look for signs and symptoms of sarcoidosis. Your doctor may also listen to your lungs and heart since abnormal breathing or abnormal heartbeat sounds could be a sign that sarcoidosis is affecting your lungs or heart.

Diagnostics Tests:

• Chest x ray
• Lung function tests
• Biopsy

Your doctor may also order other tests such as blood tests and an EKG (electrocardiogram).to evaluate if there has been any damage to your organs and determine if treatment is needed.

If sarcoidosis is diagnosed, you should see an ophthalmologist (eye specialist), even if you do not have eye symptoms. In sarcoidosis, eye damage can occur without symptoms.

Eat a healthy diet filled with fruits, vegetables, whole grains, and lean meats. Eat a diet low in saturated fats, trans fat, cholesterol, sodium, and added sugar.

Remain as physically active as you can.

Avoid smoking. If you smoke, talk to your doctor about how you can stop smoking.

Living with sarcoidosis may cause fear, anxiety, depression, and stress. If this is the case, talk to your doctor. He/she can prescribe certain medications to help. In addition, talking with a counselor can help you deal with sarcoidosis.

There are support groups that are available and can help you adjust to living with sarcoidosis.

Many women who have sarcoidosis give birth to healthy babies. Women with severe sarcoidosis, especially if they are older, may have trouble becoming pregnant. Sometimes sarcoidosis may get worse after the baby is delivered. If you have sarcoidosis and are pregnant or planning a pregnancy, talk with your doctor about the risks involved.

Sarcoidosis symptoms will often get better without any treatment.

• Corticosteroid medication, such as prednisone, can be prescribed, especially if the eyes, heart, nervous system, or lungs are affected. Prednisone reduces inflammation and in most people, prednisone relieves symptoms within a couple of months. This type of medication may need to be taken for 1 to 2 years.
  • Long-term use of prednisone, especially at high doses, can cause serious side effects. Talk to your doctor about the benefits versus risks of this medication.
  • Once you are ready to stop taking prednisone, your doctor will taper you off slowly.
• Antimalarial medicines such as hydroxychloroquine and chloroquine can also be prescribed. These medications work best for treating sarcoidosis that affects the skin or brain.
• Immunosuppressive medications such as methotrexate and azathioprine can also be prescribed. These work by supressing your immune system and work best for treating sarcoidosis that affects your lungs, eyes, skin, or joints.

If you are experiencing cough or wheezing, your doctor will more than likely prescribe you medication to be inhaled to help open the airways.

In rare cases, some persons with very severe heart or lung damage (end-stage disease) may need an organ transplant.

Researchers continue to look for new and better treatments for sarcoidosis. They are currently studying treatments aimed at the immune system.

Researchers are also studying antibiotics as a possible treatment for sarcoidosis that affects the skin.

Anti-tumor necrosis factor drugs, originally developed to treat arthritis, are being studied to treat sarcoidosis.

Many people with sarcoidosis get better without treatment. Up to half of all persons with the disease get better in 3 years without treatment. 

However, those whose lungs have been affected, may develop lung damage.

Overall death rate from sarcoidosis is less than 5%. Causes of death include:

• Bleeding from the lung tissue
• Heart damage, which can lead to heart failure and abnormal heart rhythms
• Scarring of the lungs (pulmonary fibrosis)

Possible Complications associated with sarcoidosis include:

• Fungal lung infections
• Glaucoma and blindness from uveitis (rare)
• Kidney stones caused by high calcium levels in the blood or urine
• Complications from taking corticosteroids for long periods of time such as osteoporosis
• High blood pressure in the arteries of the lungs (pulmonary hypertension)