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Sarcoidosis

• Definition of Sarcoidosis
• Description of Sarcoidosis
• Causes and Risk Factors of Sarcoidosis
• Symptoms of Sarcoidosis
• Diagnosis of Sarcoidosis
• Treatment of Sarcoidosis
• What Questions To Ask Your Doctor About Sarcoidosis

Definition of Sarcoidosis

Sarcoidosis is a multisystem (involves the entire body) granulomatous (small growths or lumps) disease that produces inflammation or swelling of the tissues in any part of the body.

Description of Sarcoidosis

In 90 percent of the diagnosed cases, the inflammation is in the lungs and is called pulmonary sarcoidosis.

However, sarcoidosis may also occur in the lymph nodes, eyes, skin, joints, spleen, liver, kidney, heart, brain, salivary glands or nervous system.

Sarcoidosis occurs more frequently in Caucasians of European descent and among African-Americans. It is most common in young people between the ages of 20 and 40 and affects women more than men.

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Causes and Risk Factors of Sarcoidosis

The cause of sarcoidosis is unknown.

Symptoms of Sarcoidosis

People with sarcoidosis may have no symptoms, only vague symptoms (such as weight loss, fever and a general "ill feeling"), or symptoms associated with a specific organ(s).

Up to half of sarcoidosis patients have no symptoms when the illness is diagnosed, thus making the diagnosis difficult. Listed below are some signs and symptoms associated with specific organ involvement:

Lungs

• Shortness of breath
• Wheezing
• Hoarseness
• Dry cough with phlegm
• Chest pain
• Tightness in the chest

Lymph nodes

• Enlargement

  Iridocyclitis (inflammation or swelling of the colored part of the eye)

• Red or watery
• Burning or itching
• Blurred vision
• Dry eye
• Photophobia (aversion to light)

Skin

• Small, raised pink or purplish patches on the face
• Erythema nodosum (painful red blotches found mostly on the legs with accompanying joint pain (arthritis) in knees, ankles, elbows and wrist)
• Lupus pernio (rash that develops slowly on the nose, face and ears)
• Painful nodules (lumps) under the skin

Bone

• Nodules in the bone
• Joint and muscle pain
• Sunken lesions on fingers and toes

Spleen and Liver

• Enlargement

Heart

• Irregular heartbeats

Brain and Nervous System

• Loss of sensation
• Loss of muscle strength
• Headache
• Dizziness
• Seizure
• Meningitis

Diagnosis of Sarcoidosis

To diagnose sarcoidosis the doctor will perform a physical exam and run a variety of laboratory tests and diagnostic procedures. During the physical exam, the doctor may discover enlarged, tender lymph nodes and a dry cough. If eye problems are detected, the doctor will refer the patient to an ophthalmologist (eye specialist). The ophthalmologist will use a slit lamp to detect inflammation of the eye.

The laboratory and diagnostic tests may include the following:

Chest x-ray. A chest x-ray is a picture of the lungs, heart, as well as the surrounding tissues containing lymph nodes. The doctor will look for enlarged lymph nodes and small round spots in the lung caused by the granulomas.

Pulmonary Function Tests (PFTs). These tests can show obstruction of air flow out of the lungs, restriction of the lung's ability to take in air and a decrease in the transport of oxygen from the lung into the blood stream.

Blood tests. Blood samples are taken and analyzed under a microscope to evaluate the number and types of blood cells in the body and how well the cells are functioning. They can also measure the levels of blood proteins and calcium as well as detect abnormal liver function.

Biopsy (removal of a sample of tissue). The physician may biopsy the skin, lymph nodes, or salivary glands to help make a diagnosis.

Treatment of Sarcoidosis

People with the acute form of sarcoidosis may only need treatment to relieve the discomfort of symptoms such as skin sores, joint inflammation, and muscle pain.

The treatment for joint inflammation includes exercise, joint protection and medication to reduce the inflammation. The medications used to treat joint inflammation are called non-steroidal anti-inflammatory drugs (NSAIDs).

For those people who have severe symptoms or whose disease has spread to internal organs, corticosteroid drugs may be needed.

Corticosteroids, such as prednisone, are man-made drugs that help reduce pain and inflammation. These drugs may improve lung function, reduce granuloma formation and reduce scarring of the lungs. To relieve skin problems, a topical cream is prescribed. Corticosteroid drops are available for eye problems.

Treatment with corticosteroids is generally administered over several years or throughout a person's lifetime. If the drugs are stopped, the condition may reappear.

Frequent checkups are important for the doctor to monitor the illness and minimize the considerable side effects of corticosteroids such as mood swings, swelling, weight gain, high blood sugar, and high blood pressure. However, if the corticosteroid is taken in carefully prescribed, low doses, the benefits from the treatment are usually far greater than the associated problems.

Various other drugs have been tried besides corticosteroids, but their effectiveness has not been established in controlled studies.

What Questions To Ask Your Doctor About Sarcoidosis

Are there any tests that need to be done to diagnose sarcoidosis

or to rule out any other disease?

How serious is the condition? How many systems are involved?

Is this disease a chronic condition?

What type of treatment do you recommend?

How effective is this type of treatment?

Will you be prescribing any medication? What are the side effects?