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Sarcoidosis

  • Definition
    • Sarcoidosis is a disease in which inflammation occurs in the lymph nodes, lungs, liver, eyes, skin, or other tissues.

  • Causes
    • The exact cause of sarcoidosis is unknown. What is known is that when a person has the disease, tiny clumps of abnormal tissue (granulomas) form in certain organs of the body. Granulomas are clusters of immune cells.

      The disease can affect almost any organ. It most commonly affects the lungs.

      Doctors think that having certain genes makes it more likely for a person to develop sarcoidosis. Things that may trigger the disease include infections with bacteria or viruses. Contact with dust or chemicals may also be triggers.

      The disease is more common in African Americans and Caucasians of Scandinavian heritage. More women than men have the disease.

      The disease often begins between ages 20 and 40. Sarcoidosis is rare in young children.

      A person with a close blood relative who has sarcoidosis is nearly five times as likely to develop the condition.

  • Symptoms
    • There may be no symptoms. When symptoms do occur, they can involve almost any body part or organ system.

      Almost all people affected by sarcoidosis have lung or chest symptoms:

      Symptoms of general discomfort:

      Skin symptoms:

      • Raised, red, firm skin sores (erythema nodosum), almost always on the front part of the lower legs
      • Rash
      • Scars that become raised or inflamed

      Nervous system symptoms may include:

      Eye symptoms include:

      • Burning
      • Discharge from the eye
      • Dry eyes
      • Itching
      • Pain
      • Vision loss

      Other symptoms of this disease:

      • Dry mouth
      • Fainting spells, if the heart is involved
      • Nosebleed
      • Swelling in the upper part of the abdomen
      • Liver disease
  • Exams and Tests
  • Treatment
    • Sarcoidosis symptoms will often get better without treatment.

      If the eyes, heart, nervous system, or lungs are affected, corticosteroid medicine is usually prescribed. This medicine may need to be taken for 1 to 2 years.

      Medicines that suppress the immune system (immunosuppressive medicines) are sometimes also needed.

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

  • Outlook (Prognosis)
    • Many people with sarcoidosis are not seriously ill, and they get better without treatment. Up to half of all people with the disease get better in 3 years without treatment. People whose lungs are 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, leading to heart failure and abnormal heart rhythms
      • Lung scarring (pulmonary fibrosis)
  • Possible Complications
      • Fungal lung infections (aspergilloma)
      • Glaucoma and blindness from uveitis (rare)
      • Kidney stones from high calcium levels in blood or urine
      • Osteoporosis and other complications of taking corticosteroids for long periods of time
      • High blood pressure in the arteries of the lungs (pulmonary hypertension)
  • When to Contact a Medical Professional
  • References
    • Judson MA, Morgenthau AS, Baughman RP. Sarcoidosis. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 66.

      Valeyre D, Prasse A, Nunes H, Uzunhan Y, Brillet PY, MĂĽller-Quernheim J. Sarcoidosis. Lancet. 2014; 383(9923):1155-1167. PMID: 24090799 www.ncbi.nlm.nih.gov/pubmed/24090799.