Sarcoidosis

Sarcoidosis Overview

Sarcoidosis is an inflammatory disease that can affect almost any organ in the body, although it most commonly appears in the lungs. In general, this disease causes heightened immunity, meaning that instead of your immune system protecting your body from disease and infection, it overreacts and causes damage to organs and tissues.

The classic feature of sarcoidosis is the formation of microscopic clumps of cells called granulomas. When too many of these clumps appear in an organ of the body, it can hamper bodily functions. In addition to the lungs, these cell clumps also often appear in the lymph nodes, eyes and skin.

There are no known causes of sarcoidosis, but it may be due to excessive sensitivity to environmental factors, genetics or an extreme immune response to infection.

Symptoms

Signs and symptoms of sarcoidosis vary greatly depending upon the person, the organs or tissues affected and the length of time a person has been affected with the disease. Often, a person displays no symptoms of the disease, so it may not be discovered until it appears in a chest x-ray.

If the disease occurs in the lungs or chest, you may experience:

Dry cough
Shortness of breath
Discomfort behind your breast bone
Abnormal breathing sounds
General discomfort including malaise, fatigue, fever, weight loss, night sweats and joint pain

If the disease occurs in the skin, you may observe:

Skin rashes
Old scars raising above the skin
Raised, red, firm skin sores, most often on the front part of the legs (erythema nodosum)
Discoloration of the nose, cheeks, lips and ears (lupus pernio)
Skin lesions
Hair loss

If the disease occurs in your nervous systems or your eyes, you may experience:

Headaches
Seizures
Weakness or paralysis on one side of the face
Burning sensations, itching or discharge in the eyes
Decreased tearing

Other symptoms of the disease include enlarged lymph glands, such as a lump in the armpit, on the neck or in the groin; palpitations; an enlarged liver or spleen; dry mouth or nosebleed.

Risk Factors

Although anyone can develop sarcoidosis, the disease most often occurs between the ages of 20 and 40 and more often in women than men. In the US, Black people are more likely to have the disease. You are more likely to be at risk if someone in your family has had sarcoidosis.

Sarcoidosis Prevention

Sarcoidosis remains a somewhat mysterious disease, so efforts to prevent any outbreak may not be successful all of the time.

Reduce Your Risk of Sarcoidosis

Quitting smoking, limiting alcoholic consumption and avoiding exposure to toxic inhalants, fumes and gases might help.

Tests and Screenings

Sarcoidosis can be difficult to diagnose because the disease produces few signs and symptoms in the early stages. When symptoms do occur, they often mimic signs and symptoms of other disorders associated with the affected organs or tissues. In many cases, sarcoidosis is discovered amid tests for other diseases and disorders.

When sarcoidosis is suspected, your Wellstar physician may order a variety of tests:

Imaging, such as a chest x-ray or computer tomography (CT) scan to reveal evidence of lung damage, enlarged lymph nodes or cell clumps called granulomas
Blood tests to check your lung and kidney functions, as well as ACE level, which is an enzyme that is sometimes a marker for active sarcoidosis.
Lung function tests that measure the volume of your lungs, the amount of air you breathe in and out, the rate of your breathing and the ability of your lungs to deliver oxygen to your blood.
Biopsies to remove and examine small tissue samples from your lungs, skin, lymph nodes and other areas that may be affected.

Sarcoidosis Diagnosis

If screening tests are abnormal your Wellstar physician will perform further evaluations regarding sarcoidosis.

Procedures

Chest X-rays
Computerized Tomography (CT) Scan
Biopsies
Lung function tests
Blood tests

Sarcoidosis Treatment

Treatment of sarcoidosis depends on the affected regions as well as the severity of the condition. In mild cases of sarcoidosis, patients may get better on their own without treatment. In other situations where organ function may be compromised, medications may be required. In extreme cases, surgery or organ transplants may become necessary.

Medication

Medicinal therapy typically takes a few years to complete. Corticosteroids, such as prednisone, generally serve as the first-line of treatment for sarcoidosis and is usually administered orally, but sometimes through an IV, an inhaler, or topical as a cream.

Anti-rejection drugs such as methotrexate (Trexall^®) and azathioprine (Imuran^®) are used to reduce inflammation by suppressing your immune systems. Hydroxychloroquine (Plaquenil^®) may be used for skin disease and sarcoidosis affecting your nervous system. Tumor necrosis factor-alpha (TNF-alpha) inhibitors are most commonly used with sarcoidosis associated with rheumatoid arthritis.

Surgery

In rare cases, your Wellstar physician may recommend more invasive treatments and surgery, including organ transplant if sarcoidosis has severely damaged your lungs or liver.

Ongoing Care for Sarcoidosis

Wellstar’s world-class, community-based physicians utilize state-of-the-art medical centers and hospitals with the latest technologies and medical resources. Our clinicians are dedicated to:

Helping you create and maintain healthy lifestyles
Offering advice to prevent illness and injuries
Providing early and appropriate care of acute illness to prevent its progression

Pulmonary Medicine at Wellstar

Wellstar Pulmonary Network provides top-flight pulmonary care throughout the Wellstar Health System. Each of Wellstar’s physicians, certified in their field, have the knowledge and skill needed to diagnose and treat all pulmonary conditions and diseases, ranging from asthma, bronchitis, emphysema, pneumonia, respiratory failure, pulmonary hypertension, lung cancer and sleep apnea. In addition, many of our providers have special training in internal medicine, pulmonary diseases and critical care medicine. As a result, you can feel confident—at every level—about your pulmonary care at Wellstar.

Ongoing Care at Home

Proper care and treatment of sarcoidosis can often improve symptoms and help you live longer. You and your Wellstar physician can work together to make your life more comfortable, so pay close attention to your body and your post-treatment regiment and keep your doctor updated. As part of your post-treatment care and in addition to maintaining a healthy diet and exercise, you should:

Seek prompt medical attention when symptoms increase in severity.
Keep track of all medications you take.
Keep track of your weight and blood pressure.
Write down your questions, and never be afraid to ask your Wellstar physicians for clarification regarding your condition or your treatment.