• Sarcoidosis

    Definition

    Sarcoidosis is a disease that causes inflammation in organs throughout the body. It forms small round spots, called granulomas, in various organs. The spots can make it difficult for the organs to work normally.

    Causes

    Inflammation is a normal part of how the body acts toward an infection or injury. However, the inflammation should pass once the area has healed. With sarcoidosis the inflammation does not pass. The cells that cause the inflammation stay and cause granulomas. It is not clear why this happens. An infection or exposure to a toxin in the environment may trigger the change.

    Risk 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:
      • Parents and siblings
      • Uncle, aunt, nephew, niece, grandparent, grandchild, and half-sibling
    • Exposures to dusty or moldy environment or certain occupations

    Symptoms

    There are few symptoms in early stages. Symptoms will depend on what organs are affected. Symptoms may come and go.
    Many will feel like they have a flu-like symptoms like:
    • Fever
    • Swollen lymph nodes
    Lungs are often affected and can cause:
    • Cough
    • Shortness of breath
    • Wheezing
    • Chest pain
    • Fatigue, especially with exertion
    • Night sweats
    Other possible symptoms may include:
    • Rash with swelling—erythema nodosum
    • Pain or irritation of eyes
    • Muscle weakness
    • Loss of appetite
    • Weight loss
    • Seizures
    • Tremors
    • Difficulty hearing
    • Blurred vision or blindness—if the eye is affected
    • Poor coordination
    • Trouble walking
    • Irregular heart rate
    • Pain, swelling, and stiffness in the joints
    • Facial paralysis known as Bell's palsy
    Bell's Palsy
    Facial droop and nerves
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    Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done including listening to the heart and lungs and checking lymph nodes. Tests that may help find sarcoidosis signs or rule out other causes include:
    • Chest x-rays—can show sarcoidosis spots in the lungs or swollen lymph nodes
    • Biopsy—to look for granulomas or signs of other conditions such as infections
    There is no specific test that confirms sarcoidosis. Instead, diagnosis is based on:
    • Combination of typical symptoms and results of imaging tests (mainly x-ray)
    • Biopsy that show granulomas may be from any organ
    • Eliminating other causes of illness
    Other tests may be done to see how well the affected organs are working. Tests may be done even if there are no symptoms and may include:

    Treatment

    No all sarcoidosis needs to be treated. Many will only have minor symptoms and the sarcoidosis will pass on its own. The doctor will monitor for any changes including regular eye exams and lung tests.
    Treatment may be needed to ease more serious symptoms. It can also help to decrease the chance of permanent problems. Treatment may include:

    Medical Care

    Medication may help to manage the inflammation and decrease damage. Options include:
    • Steroids to decrease inflammation
    • Topical steroids to treat rashes
    • Methotrexate, azathioprine, or anti-tumor necrosis factor biologics for those who do not respond to steroids
    • Nonsteroidal anti-inflammatory drugs (NSAIDs) to treat musculoskeletal symptoms
    • Eye drops to treat mild eye problems
    Pulmonary rehabilitation may help to improve lung function.

    Prevention

    There are no current guidelines to prevent sarcoidosis because the cause is unknown.

    RESOURCES

    American Lung Association http://www.lung.org

    Arthritis Foundation http://www.arthritis.org

    CANADIAN RESOURCES

    The Arthritis Society http://www.arthritis.ca

    The Lung Association http://www.lung.ca

    References

    Explore sarcoidosis. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/sarc. Updated June 14, 2013. Accessed May 13, 2016.

    Sarcoidosis. American Lung Association website. Available at: http://www.lung.org/lung-disease/sarcoidosis. Accessed May 13, 2016.

    Sarcoidosis in adults. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116787/Sarcoidosis-in-adults. Updated June 2, 2016. Accessed September 23, 2016.

    Sarcoidosis in children. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T316439/Sarcoidosis-in-children. Updated January 28, 2011. Accessed May 13, 2016.

    6/14/2016 DynaMed's Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116787/Sarcoidosis-in-adults: Soto-Gomez N, Peters JI, Nambiar AM. Diagnosis and management of sarcoidosis. Am Fam Physician. 2016;93(10:840-848.

    Revision Information

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