Sarcoidosis is a condition where small bead-like patches of inflamed cells, called granulomas, show up in the body. They usually appear in the lungs and nearby lymph nodes. Sarcoidosis can also affect other parts of the body, including the muscles, eyes, and skin.
Many people with sarcoidosis have no symptoms at all. But in others, the condition can cause long-term organ damage. For example, some people have fiber-like scar tissue in the lungs, which can cause breathing problems. Sarcoidosis may develop over time and cause symptoms that last for years, or it may show up and go away quickly.
People who have a variation of sarcoidosis, called Lofgren’s syndrome, may have symptoms that include swollen lymph nodes, fever, painful, reddened nodules, and joint pain. Lofgren’s syndrome generally tends to clear up on its own within 1 to 2 years.
More African-Americans than Caucasians have sarcoidosis in the United States.
Signs and Symptoms
Many people with sarcoidosis have no symptoms at all.
Some people with sarcoidosis in their lungs, called pulmonary sarcoidosis, may have the following signs and symptoms:
- Shortness of breath
- Fatigue and weakness
- Weight loss
- Chest pain
- Dry cough
- Enlarged lymph nodes around the lungs
When sarcoidosis affects areas of the body other than the lungs, symptoms can include:
- Enlarged lymph nodes
- Red bumps on arms, face, buttocks
- Swelling and pain in the ankles and knees
- Infections of the eye, including pink eye (conjunctivitis)
- Enlarged or inflamed liver
Researchers do not know exactly what causes sarcoidosis. Some think it is due to an overactive immune system that responds too strongly to an invading organism. Other researchers think sarcoidosis may be:
- Caused by an infection
- Caused by allergens that are breathed in or toxins found in the environment
Anyone can get sarcoidosis, although it is more common among the following:
- People of Scandinavian, Irish, African, or Puerto Rican descent
- People in their 30s or 40s
Sarcoidosis can be hard to diagnose. You may have to see several different doctors, including a pulmonologist (lung specialist). To begin, your doctor will rule out other conditions that could be causing your symptoms, such as rheumatoid arthritis. The following tests may help diagnose the condition:
- Chest x-ray
- Lung function tests
- Blood tests
- Bronchoscopy, which examines the inside of your lungs
- CT scan, MRI, or other imaging tests
- ECG (electrocardiogram)
About half of all people with sarcoidosis get better without treatment. For others, medications, such as corticosteroids, may help reduce:
- Lung problems
Lifestyle changes may help control complications, such as kidney stones or other damage. While complementary therapies for sarcoidosis have not been studied very much, they may help you feel better as part of an overall treatment plan.
If you smoke, quit. Quitting smoking can ease lung symptoms.
Sarcoidosis can be a long-lasting disease, so it is important to eat a healthy diet filled with fruits, vegetables, and whole grains.
Exercise regularly. Be sure to ask your doctor before starting a new exercise program, especially if sarcoidosis leaves you short of breath.
Corticosteroids, such as prednisone are considered the first-line treatment for lowering inflammation from sarcoidosis. Corticosteroid pills can have some serious side effects if taken in high doses for long periods. Side effects may include:
- High blood pressure
- Stomach ulcers
Your doctor will likely suggest regular check ups and tests.
Other medications sometimes used for sarcoidosis include those that suppress the immune system, such as:
- Azathioprine (Imuran)
- Infliximab (Remicade)
However, there are no long-term studies on whether these medications work to treat sarcoidosis.
Other medications that may be used include:
- Antimalarial drugs: such as hydroxychloroquine, used when the skin is affected. It may be toxic to the eyes.
- Thalidomide: being studied for sarcoidosis, used to improve lung function and treat skin problems.
- Topical therapies: including steroid creams, eye drops, nasal corticosteroids, and steroid inhalers.
Surgery and Other Procedures
Only very severe cases need surgery, such as a lung or heart transplant.