Sarcoidosis

Sarcoidosis is an inflammatory disease in which granulomas, or clumps of inflammatory cells, form in various organs. This causes organ inflammation. Sarcoidosis may be triggered by your body’s immune system responding to foreign substances, such as viruses, bacteria, or chemicals.

The areas of the body commonly affected by sarcoidosis include:

• lymph nodes
• lungs
• eyes
• skin
• liver
• heart
• spleen
• brain

 Causes and Risk Factors

What Causes Sarcoidosis?The exact cause of sarcoidosis is unknown. However, gender, race, and genetics can increase the risk of developing the condition:

• Sarcoidosis is more common in women than in men.
• People of African-American descent are more likely to develop the condition.
• People with a family history of sarcoidosis have a significantly higher risk of getting the disease.

Sarcoidosis rarely occurs in children. Symptoms usually appear in people between the ages of 20 and 40.                Symptoms

What Are the Symptoms of Sarcoidosis?

Some people with sarcoidosis don’t have any symptoms. However, general symptoms may include:

• fatigue
• fever
• weight loss
• joint pain
• dry mouth
• nosebleeds
• abdominal swelling

Symptoms vary depending on the part of your body that’s affected by the disease. Sarcoidosis can occur in any organ, but it most commonly affects the lungs. Lung symptoms can include:

• a dry cough
• shortness of breath
• wheezing
• chest pain around your breastbone

Skin symptoms can include:

• skin rashes
• skin sores
• hair loss
• raised scars

Nervous system symptoms can include:

• seizures
• hearing loss
• headaches

Eye symptoms can include:

• dry eyes
• itchy eyes
• eye pain
• vision loss
• a burning sensation in your eyes
• a discharge from your eyes

 Diagnosis

How Is Sarcoidosis Diagnosed?

It can be difficult to diagnose sarcoidosis. Symptoms can be similar to those of other diseases, such as arthritis or cancer. Your doctor will run a variety of tests to make a diagnosis.

Your doctor will first perform a physical examination to:

• check for skin bumps or a rash
• look for swollen lymph nodes
• listen to your heart and lungs
• check for an enlarged liver or spleen

Based on the findings, your doctor may order additional diagnostic tests:

• A chest X-ray can be used to check for granulomas and swollen lymph nodes.
• A chest CT scan is an imaging test that takes cross-sectional pictures of your chest.
• A lung function test can help determine whether your lung capacity has become affected.
• A biopsy involves taking a sample of tissue that can be checked for granulomas.

Your doctor may also order blood tests to check your kidney and liver function.

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 drycough, 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 is 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.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).
    • CT scan 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.Sarcoidosis is a rare condition that causes small patches of red and swollen tissue, called granulomas, to develop in the organs of the body. It usually affects the lungs and skin.The symptoms of sarcoidosis depend on which organs are affected, but typically include:
      • tender, red bumps on the skin
      • shortness of breath
      • a persistent cough
      There’s no cure for sarcoidosis, but the condition often improves without treatment within a few months or years. The symptoms aren’t usually severe and don’t tend to affect everyday life.
      

      Symptoms of sarcoidosis

      It’s impossible to predict how sarcoidosis will affect a person, as the condition can affect any organ and the symptoms vary widely depending on which organs are involved. Some people don’t have any symptoms at all, and the condition is diagnosed after an X-ray carried out for another reason.Sarcoidosis most often affects the lungs, skin and/or lymph nodes (glands). Some of the typical symptoms are listed below, although someone with sarcoidosis will probably only have a few of these.The lungs are affected in about 90% of people with sarcoidosis. This is known as pulmonary sarcoidosis.

      Skin symptoms

      The skin is affected in about 25% of people with sarcoidosis.

      Other symptoms

      If other organs are affected, you may also have some of the following symptoms:
      • tender and swollen glands in the face, neck, armpits or groin
      • tiredness and a general feeling of being unwell
      • painful joints
      • red or sore eyes
      • an abnormal heart rhythm
      • a blocked or stuffy nose
      • pain in the bones
      • kidney stones
      • headache

      Causes of sarcoidosis

      The body’s immune system normally fights off infections by releasing white blood cells into the blood to isolate and destroy the germs. This results in inflammation (swelling and redness) of the body tissues in that area. The immune system responds like this to anything in the blood it doesn’t recognise, and dies down when the infection has been cleared.There are many similar conditions, such as rheumatoid arthritis andlupus, that are caused by the body attacking its own tissues. These are collectively known as autoimmune conditions.It’s possible that some environmental factor triggers the condition in people who are already genetically susceptible to it.

      Who’s affected

      Sarcoidosis can affect people of any age, but usually starts in young adults aged between 20 and 40. It’s rare in childhood.

      Diagnosing sarcoidosis

      A number of different tests may be carried out to diagnose sarcoidosis, depending on which organs are affected.In some cases, doctors may want to examine the inside of your lungs using a long, thin, flexible tube with a light source and a camera at one end (endoscope) that’s passed down your throat. A small sample of lung tissue may also be removed during this test so it can be studied under a microscope. This is known as a biopsy.

If doctors think you may have sarcoidosis affecting other organs – such as the skin, heart or eyes – scans or examinations of these areas will usually be carried out.

There’s no cure for sarcoidosis. However, symptoms often improve without treatment. Your doctor may prescribe medications if your inflammation is severe. These can include corticosteroids or anti-rejection medications, which can both help reduce inflammation.

Treatment is also more likely if the disease affects your:

• eyes
• lungs
• heart
• nervous system

The length of any treatment will vary. Some people take medication for one to two years. Other people may need to be on medication for much longer.