Sarcoidosis is an inflammatory disease that may affect many different parts of the body. Small round spots, called granulomas, form in various organs. The spots slow down normal functioning of those organs.
The cause of sarcoidosis is not known. It seems to be related to malfunctioning of the immune system. The disease may be triggered by an infection or exposure to a toxin in the environment.
Some people may be more susceptible to sarcoidosis due to genetic or environmental factors.
Sarcoidosis is more common in females and at ages 20 to 40 years old. Factors that may increase the chance of sarcoidosis include:
- Ethnic descent—African-American, Northern European, Scandinavian, and Irish
- History of sarcoidosis in:
- First-degree relative—parents and siblings
- Second degree relatives—uncle, aunt, nephew, niece, grandparent, grandchild, and half-sibling
- Exposures to dusty or moldy environment orcertain occupations.
Symptoms vary and can occur in different parts of the body, depending on where the granulomas form. Most symptoms develop in the lungs, skin, eyes, and liver. Multiple body systems may be affected. Symptoms may come and go. This disease is often acute, but in some people, it is chronic.
Symptoms may include:
- Shortness of breath
- Chest pain
- Rash with swelling—erythema nodosum
- Pain or irritation of eyes
- Fatigue, especially with exertion
- Muscle weakness
- Night sweats
- Loss of appetite
- Weight loss
- Swollen lymph nodes
- Difficulty hearing
- Blurred vision or blindness
- Poor coordination
- Trouble walking
- Irregular heart rate
- Pain, swelling, and stiffness in the joints
- Facial paralysis known as Bell's palsy
The doctor will ask about your symptoms and medical history. A physical exam will be done. An eye exam may also be done. There is no specific lab test that confirms a diagnosis of sarcoidosis, but tests may include:
- Blood tests
- Urine tests
Imaging tests evaluate bodily structures. These may include:
Your heart activity may be tested. This can be done with an electrocardiogram (EKG).
Your lung function may be tested. This can be done with pulmonary function tests (PFTs).
Diagnosis is based on all of the following criteria:
- The combination of typical symptoms and results on imaging tests (mainly an x-ray)
- Biopsy that shows the presence of granulomas (from the easiest organ to get tissue samples from)
- Exclusion of other causes
Treatment aims to ease symptoms and minimize permanent problems. Treatment may include:
You need regular medical and eye exams to monitor for symptoms and complications of sarcoidosis.
Drugs that may be prescribed include the following:
- Steroids to decrease inflammation
- Methotrexate, azathioprine, or anti-tumor necrosis factor biologics may be used for those who do not respond to steroids
- Hydroxychloroquine to treat skin problems
- Nonsteroidal anti-inflammatory drugs (NSAIDs) to treat musculoskeletal symptoms
- Pulmonary rehabilitation programs to improve lung function
- Topical steroids to treat rashes
- Eye drops to treat mild eye problems
To help minimize your symptoms:
- If you smoke, talk to your doctor about how to successfully quit.
- Avoid exposure to dust and chemicals.
- Notify your doctor at right away if any symptoms develop or worsen.
- Reviewer: Michael Woods, MD
- Review Date: 05/2016 -
- Update Date: 06/14/2016 -