Sarcoidosis-Symptoms, Treatment, Prevention

Sarcoidosis is a rare condition in which groups of immune cells form lumps, called granulomas, in various organs in the body. Inflammation, which may be triggered by infection or exposure to certain substances, is thought to play a role in the formation of granulomas.

Sarcoidosis can affect any organ. Most often it affects the lungs and lymph nodes in the chest. You may experience fatigue, which is extreme tiredness, or fever, but you may also experience other signs and symptoms depending on the organ that is affected. Your doctor will diagnose sarcoidosis in part by ruling out other diseases that have similar symptoms.

Causes

Environmental factors, such as infection or exposure to certain substances, can trigger changes in the immune system and lead to sarcoidosis. Studies suggest that these triggers may cause sarcoidosis only in people with genes that make them susceptible to the disease.

Symptoms

Many people have general signs and symptoms, such as:

  • Depression
  • fatigue
  • Fever
  • Malaise, or a feeling of discomfort or illness
  • Pain and swelling in the joints
  • Weight loss

Sarcoidosis most often affects the lungs and the lymph node in the chest. Some people with sarcoidosis in the lungs may wheeze, cough, feel short of breath, or have chest pain. However, people with sarcoidosis in the lungs do not always have lung-related symptoms.

If sarcoidosis affects other organs or parts of your body, you may have other symptoms related to those organs:

  • Abdominal pain
  • A larger than normal spleen
  • Anemia
  • Burning, itchy, or dry eyes
  • Fainting
  • Heart palpitations
  • Joint pain
  • Muscle weakness
  • Problems with a liver that is larger than normal, including itching, vomiting, nausea, jaundice, or abdominal pain
  • Problems with the nervous system, including headache, dizziness, vision problems, seizures, mood swings, disturbed behavior, hallucinations, delusions, back pain, or pain associated with particular nerves
  • Skin changes, including erythema nodosum or lupus pernio, a condition that causes skin sores that usually affect the face, especially the nose, cheeks, lips, and ears. The sores associated with lupus pernio tend to last a long time. Lupus pernio occurs mostly in African Americans and can return after sarcoidosis treatment is over.
  • Swelling of the salivary glands
  • Swollen or tender lymph nodes in other areas of the body besides the chest, such as in your neck, chin, armpits, or groin

Complications

If sarcoidosis is untreated or if the treatment does not work, inflammation can continue and scarring may develop. Sarcoidosis can cause serious and life-threatening damage to the organs it affects, including:

  • Blindness
  • Blood and bone marrow problems, including lower-than-usual numbers of red or white blood cells
  • Endocrine conditions, including hypercalcemiaexternal link, diabetes insipidus, and amenorrhea
  • Heart complications, including arrhythmia, heart failure, sudden cardiac arrest, cardiomyopathy
  • Kidney conditions, such as kidney stones or kidney failure
  • Cirrhosis
  • Lung diseases, such as pulmonary hypertension and pulmonary fibrosis
  • Problems with the nervous system, including brain tumors, meningitis, hydrocephalus, psychiatric problems, and nerve pain

Treatment

The goal of treatment is remission, a state in which the condition is not causing problems. Not everyone who is diagnosed with sarcoidosis needs treatment. Sometimes the condition goes away on its own. Whether you need treatment—and what type you need—will depend on your signs and symptoms, which organs are affected, and whether those organs are working well. Some people do not respond to treatment.

Because inflammation is thought to be involved in sarcoidosis, your doctor may prescribe medicines to reduce inflammation or treat an overactive immune system that may be causing too much inflammation in the body. Some of the medicines include:

  • Corticosteroids to reduce inflammation. The corticosteroid prednisone is the most commonly used treatment for sarcoidosis. Corticosteroids can be taken as pills or be injected, inhaled, or taken as eye drops or other topical medicines. Corticosteroids can have serious side effects with long-term use.
  • Disease-modifying antirheumatic drugs (DMARDs) to treat an overactive immune system. Examples of DMARDs include methotrexate, azathioprine, and leflunomide. Potential side effects include liver damage.
  • Monoclonal antibodies to treat an overactive immune system. Examples include infliximab, adalimumab, rituximab, and golimumab.
  • Antibiotics to treat sarcoidosis of the skin. Side effects of common antibiotics, such as minocycline, tetracycline, and doxycycline, include dizziness and gastrointestinal problems.
  • Antimalarials to treat sarcoidosis of the skin, lungs, or nervous system. These medicines are typically used to fight malaria. Side effects include eye damage.
  • Colchicine to treat joint pain from sarcoidosis. This medicine is usually prescribed for gout. Side effects include nausea, vomiting, diarrhea, and stomach cramps or pain.
  • Corticotropin to treat an overactive immune system. This is a type of hormone therapy. Side effects include changes to appetite or mood.
  • Pentoxifylline to block the release of TNF-a, a substance in white blood cells that can cause granulomas. This medicine is normally prescribed to improve blood flow. Side effects include nausea.

Prevention

Currently, there are no screening methods to determine who will develop sarcoidosis. If you are at risk for sarcoidosis, your doctor may recommend you try to avoid insecticides, mold, or other environmental sources of substances known to trigger the formation of granulomas.

 

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.