Sarcoidosis

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Introduction

What is sarcoidosis?

Sarcoidosis is a type of inflammation that occurs in various locations of the body for no known reason. Sarcoidosis is not infectious. Normally, when foreign substances or germs enter your body, your immune system will fight back by activating an immune response. Inflammation is a normal part of this immune response, but it should subside once the foreign substance or germs are gone. If you have sarcoidosis, the inflammation persists, and some of the immune cells form abnormal clumps of tissue called granulomas.

The disease can affect any organ in the body, but it is most likely to occur in the lungs. It can also affect the skin, eyes, liver, or lymph nodes. Although the cause of sarcoidosis is not known, research suggests that it may be due to an extreme immune response or extreme sensitivity to certain substances. It also seems to have a genetic component, meaning that it tends to run in families. Sarcoidosis most commonly develops in people who are between 20 and 50 years of age. African Americans are somewhat more likely to develop sarcoidosis than Caucasians, and females are somewhat more likely to develop sarcoidosis than males (Source: NHLBI).

The symptoms of sarcoidosis depend on the organ affected. When sarcoidosis occurs in the lungs, it can lead to wheezing, coughing, shortness of breath, and chest pain. Other possible symptoms that affect other body systems include night sweats, fever, weight loss, and seizures. In children, common symptoms include fatigue, loss of appetite, night sweats, and bone and joint pain. Some cases of sarcoidosis resolve on their own, while others may last indefinitely. Treatment for sarcoidosis is designed to reduce inflammation and includes corticosteroids and immunosuppression therapy. Healthy lifestyle practices, including following a well-balanced diet, not smoking, and getting plenty of exercise, can help you manage your disease.

In some cases, sarcoidosis can be associated with serious or life-threatening symptoms. Seek immediate medical care (call 911) if you, or someone you are with, have serious symptoms, such as difficulty breathing, severe chest pain, bluish coloration of the lips or fingernails, loss or change of vision, change in level of consciousness or alertness, or seizures.

Seek prompt medical care if you are being treated for sarcoidosis but mild symptoms recur or are persistent.

Symptoms

What are the symptoms of sarcoidosis?

The symptoms of sarcoidosis depend on the organ that is affected. Sarcoidosis is most likely to occur in the lungs, but it also commonly affects the skin, eyes, liver, or lymph nodes.

Common symptoms of sarcoidosis

Sarcoidosis may result in a number of symptoms, which may become severe at any time. Symptoms of sarcoidosis include:

    Serious symptoms that might indicate a life-threatening condition

    In some cases, sarcoidosis can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

    • Bluish coloration of the lips or fingernails

    • Change in level of consciousness or alertness, such as passing out or unresponsiveness

    • Rapid heart rate (tachycardia)

    • Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking

    • Seizure

    • Sudden change in vision, loss of vision, or eye pain

    Causes

    What causes sarcoidosis?

    Sarcoidosis is characterized by inflammation and granulomas (clumps of immune cells) that can occur in any organ of the body, but most commonly affect the lungs. Although the cause of sarcoidosis is not known, research suggests that it may be due to an extreme immune response or extreme sensitivity to certain substances. It also seems to have a genetic component, meaning that it tends to run in families. It is not infectious.

    What are the risk factors for sarcoidosis?

    A number of factors may increase the risk of developing sarcoidosis. Not all people with risk factors will get sarcoidosis. Risk factors for sarcoidosis include:

    • Asthma and allergies
    • Exposure to gardening, building or hardware materials
    • Exposure to insecticides, pesticides, mold, or agricultural dust
    • Exposure to smoke and fumes from fire
    • Family history of sarcoidosis
    • Female gender
    Treatments

    How is sarcoidosis treated?

    Treatment for sarcoidosis begins with seeking medical care from your health care provider. The primary goal of treatment for sarcoidosis is to decrease inflammation and reduce the size of granulomas. Treatment can also help to reduce symptoms, increase organ function, and prevent pulmonary fibrosis (scarring of the lungs). Treatment will depend on the severity and location of the sarcoidosis.

    Treatment options for sarcoidosis

    Treatment options for sarcoidosis include:

    • Anti-inflammatory drugs such as hydroxychloroquine (Plaquenil)

    • Bronchodilators, inhalers that open the breathing passages, such as albuterol (ProAir, Proventil, Ventolin)

    • Corticosteroids such as prednisone (Deltasone)

    • Immunosuppressive agents such as methotrexate (Trexall)

    • Pain medications, such as aspirin and ibuprofen (Advil, Motrin)

    What are the potential complications of sarcoidosis?

    Complications of untreated sarcoidosis can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of sarcoidosis include:

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    Medical Reviewer: William C. Lloyd III, MD, FACS
    Last Review Date: 2018 Nov 18
    1. Domino FJ (Ed.) Five Minute Clinical Consult. Philadelphia: Lippincott Williams & Wilkins
    2. Sarcoidosis. MedlinePlus, U.S. National Library of Medicine. https://medlineplus.gov/sarcoidosis.html
    3. What is sarcoidosis? National Heart, Lung, and Blood Institute Diseases and Conditions Index. http://www.nhlbi.nih.gov/health/dci/Diseases/sarc/sar_whatis.html
    4. Thomas KW, Hunninghake GW. Sarcoidosis. JAMA 2003; 289:3300
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