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Diseases A–Z

Sarcoidosis

Causes | Symptoms | Treatment | If you have sarcoidosis

Sarcoidosis is a chronic condition that may affect almost any part of the body. Sarcoidosis causes persistent nodular inflammation (swelling) of the tissues. The most common tissues affected by sarcoidosis are lungs, lymph nodes, eyes, skin, liver and spleen. Almost any tissue or organ of the body may be affected.

What causes sarcoidosis?

The cause of sarcoidosis is still unknown. It was once thought to be a form of tuberculosis but this is now known not to be the case. Most evidence suggests that sarcoidosis represents a reaction of the body to some as yet unidentified environmental agent or agents. Viruses have been implicated, but definite proof is lacking.

It is possible that people with sarcoidosis have a disorder of their immune mechanisms that makes them susceptible to the disease. In such a situation, it is postulated that the inhalation of some environmental agent stimulates the immune system to produce an inflammatory response as an attempt to rid the body of this inhaled triggering factor. This immune reaction in the tissues is responsible for creating the inflammatory nodules which characterize the condition known as sarcoidosis.

Although sarcoidosis is characterized by the presence of nodular swellings in the involved tissues, there is no evidence to suggest that it is a malignant disease. Nevertheless, the inflammatory nodules of sarcoidosis can interfere with normal functioning of the involved tissues and organs.

Sarcoidosis is not contagious- you can't catch it from someone else.

Who is at risk for sarcoidosis?

Anyone can get sarcoidosis, but it's more common in women than men, and more common in people between the ages of 20 and 40. In North America, African-Americans are more likely to get sarcoidosis than Caucasians, but this is not the case oin other continents.

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What are the symptoms of sarcoidosis?

Because sarcoidosis can affect virtually any organ or tissue of the body, it can cause different symptoms in different people.

Signs and symptoms when sarcoidosis affects the lungs:

  • sometimes there are no symptoms at all, and the disease is discovered incidentally from a chest x-ray taken for another reason.
  • Sometimes people feel short of breath, cough, chest pain or a sense of heaviness in the chest

Other symptoms of sarcoidosis:

  • sores on the skin
  • enlarged lymph glands
  • visual disturbances

If you have these symptoms, or if you think you have sarcoidosis, see your doctor. Your symptoms could be caused by sarcoidosis, or they could be caused by another disease; only a doctor can tell.

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How sarcoidosis is diagnosed

When sarcoidosis involves the lungs, it may be recognized by your doctor from the characteristic appearance seen on chest x-ray. When the x-ray appearance is atypical, biopsy of the Iungs at bronchoscopy or at surgery may be required to confirm the diagnosis. Biopsies of lymph glands, the liver, salivary glands or the skin may be necessary in other situations.

How does sarcoidosis progress?

Sarcoidosis can be a mild or a severe disease. Even with fairly extensive sarcoidosis, people can usually continue to work. However, if sarcoidosis enters a chronic stage, lung insufficiency and/or heart failure may result and can be disabling.

Sarcoidosis is a disease that often improves spontaneously, although this may take several months. Indeed, by far the majority of people with sarcoidosis get well without any treatment. Others, however, may require treatment if the sarcoidosis involves vital organs such as the eyes, heart, or kidneys. Treatment may be necessary for varying periods of time, from several months to indefinitely.

Although sarcoidosis usually heals itself, or responds to therapy, a few people are destined to become permanently disabled because of lung or heart failure or both. Other consequences may be blindness from glaucoma, disfigurement of the skin and kidney failure.

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Treatment for sarcoidosis

There is no specific cure for sarcoidosis. Generally it must run its course and this may take several months. Remember that most cases of sarcoidosis heal spontaneously and require no specific treatment at all. If the doctor feels that treatment is necessary for a given case, the usual drugs chosen are cortisone-like medications such as Prednisone. These drugs are chosen because of their powerful anti-inflammatory properties which help to suppress the inflammation of sarcoidosis and melt away the inflammatory nodules. Treatment of sarcoidosis may need to be prolonged, and flare ups may occasionally occur when the treatment stops.

Medication is usually indicated whenever the lung involvement is sufficient to produce significant breathlessness or distressing cough. Medication is also required whenever vision is threatened or when the heart or kidneys are involved.

Although cortisone medications have well-recognized side effects such as facial puffiness, aggravation of peptic ulcers and thinning of the bones, their use is justified in sarcoidosis in order to prevent permanent organ damage due to unchecked inflammation and scarring. Usually it is possible to select doses of cortisone which are associated with very minimal side effects. These reactions are not permanent and will subside once the cortisone can be safely withdrawn.

Preventing sarcoidosis

Since it is not known what causes sarcoidosis, there is no known way to prevent its occurrence in a given individual. As continuing research into the nature of sarcoidosis expands our knowledge, prevention or cure may both some day be feasible.

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If you have sarcoidosis:
  • avoid too much direct sunlight. Vitamin D sensitivity may occur with sarcoidosis, and excessive exposure to sunlight can result in increased calcium in the blood which may in turn produce kidney damage.
  • Keep all your doctor's appointments and take your medications as prescribed
  • Don't smoke; if you do smoke, quit smoking. Continued smoking causes lung damage, and this can be even more disabling if you have sarcoidosis.

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