What is sarcoidosis?
Sarcoidosis is an inflammatory disease that affects multiple organs in the body, but mostly the lungs and lymph glands. In patients with sarcoidosis, abnormal masses or nodules (called granulomas) consisting of inflamed tissues form in certain organs of the body. These granulomas might alter the normal structure and possibly the function of the affected organ(s).
Who is at risk for the disease?
Sarcoidosis most often occurs between 20 and 40 years of age, and is diagnosed more often in women than in 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 4 in 10,000 people in the United States have sarcoidosis.
What causes sarcoidosis?
The exact cause of sarcoidosis is not known. The disease is 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.
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 dry cough, fatigue, and shortness of breath. Other symptoms and disease characteristics might 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
- Nasal stuffiness and 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 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 might begin suddenly and/or severely, and subside in a short period of time. Others might have no outward symptoms at all even though organs are affected. Still others might have symptoms that appear slowly and subtly, but which last or recur over a long time span.
How is sarcoidosis diagnosed?
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 following are the main tools your doctor will use to diagnose sarcoidosis.
- Chest X-rays look for cloudiness (pulmonary infiltrates) or swollen lymph glands (lymphadenopathy).
- CT scan provides an even more detailed look at the lungs and lymph glands than provided by a chest X-ray.
- Pulmonary function (breathing) tests measure how well the lungs are working.
- Bronchoscopy involves passing a small tube (bronchoscope) down the trachea (windpipe) and into the bronchial tubes (airways) of the lungs. The purpose of this test is to inspect the bronchial tubes and to extract a small tissue sample (biopsy) to look for granulomas and to obtain material to rule out infection.
How is the condition treated?
There is no cure for sarcoidosis, but the disease might get better on its own over time. Many people with sarcoidosis have mild symptoms and do not require any treatment. Treatment, when it is needed, is given to reduce symptoms and to maintain the proper working order of the affected organs.
Treatments generally fall into two categories — maintenance of good health practices and drug treatment. Good health practices include:
- Getting regular check-ups with your health care provider
- Eating a well-balanced diet with a variety of fresh fruits and vegetables
- Drinking 8 to 10, 8-ounce glasses of water a day
- Getting 6 to 8 hours of sleep each night
- Exercising regularly, and managing and maintaining your weight
- Quitting smoking
Drug treatments are used to relieve symptoms and reduce the inflammation of the affected tissues. The oral corticosteroid prednisone is the most commonly used treatment. Fatigue and persistent cough are usually improved with steroid treatment. If steroids are prescribed, the patient should see their doctors at regular intervals so that he or she can monitor the disease and the side effects of treatment. Other drug treatment options include methotrexate and hydroxychloroquine, and other drugs.
What can happen as the disease progresses?
In many people with sarcoidosis, the disease appears briefly and then disappears without the person even knowing they have the disease. Twenty percent to 30 percent of people have some permanent lung damage. For 10 percent to 15 percent, sarcoidosis is a chronic condition. In some people, the disease might result in the deterioration of the affected organ. Sarcoidosis can be fatal in up to 5 percent of patients.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 12/4/2006
