Sarcoidosis: what kind of disease it is, symptoms, and how it is detected

Sarcoidosis is a disease in which small dense formations made of immune system cells — granulomas — appear in the organs. Most often the lungs and lymph nodes are affected. Below is what is known about the causes, symptoms, and examinations.

Sarcoidosis: what it is

Sarcoidosis is an inflammatory disease in which granulomas form in affected tissues. These are limited foci of inflammation in the form of a dense nodule (Wikipedia). Granulomas are small areas of inflamed (swollen) tissue.

The disease is systemic: granulomas appear in any organ (MedlinePlus). Sarcoidosis is not infectious and is not transmitted from person to person. In some people the symptoms resolve on their own within several months or years — the acute form. In others the disease develops gradually and worsens over time — chronic sarcoidosis. Sometimes there are no complaints, and the diagnosis is made after an X-ray performed for another reason.

Sarcoidosis cannot be cured, but symptoms are usually controllable with medication. Another name is Besnier–Boeck–Schaumann disease (Wikipedia). In Europe there are about 40 cases per 100,000 population (Wikipedia).

Why sarcoidosis occurs and who is at risk

The exact cause is unknown (Wikipedia). Possible factors include environmental substances: mold, wood-burning stoves, soil, tree pollen, insecticides, silica; viral and bacterial infections; heredity; an autoimmune reaction.

The disease usually begins in adults aged 30–40, is rare in children, and is more common in women. The risk is higher in people over 55, in people of African and Scandinavian origin, in those living or working near insecticides and mold, in those who have a close relative with sarcoidosis, and in those taking certain anti-HIV drugs and monoclonal antibodies (MedlinePlus).

Which organs the disease affects

The lungs are affected in approximately 9 out of 10 patients. Chest lymph nodes are most often affected together with them (MedlinePlus). The skin is affected in many: painful bumps or spots, especially on the lower legs and arms, red-brown or purple.

The liver and spleen are often affected, less often the skin, bones, and organs of vision (Wikipedia). The eyes, heart, nervous system, and kidneys may be involved (MedlinePlus). Cardiac involvement is typical in Japanese people, and erythema nodosum in Europeans (Wikipedia).

Symptoms of sarcoidosis

Manifestations depend on the affected organs. In the pulmonary form, the main signs are shortness of breath and a persistent dry cough. Chest pain is also possible (MedlinePlus).

General symptoms (MedlinePlus):

• fatigue;
• weight loss;
• enlarged lymph nodes;
• fever;
• night sweats.

Other signs: painful and enlarged nodes on the face, neck, in the armpits or groin, joint pain, red or painful eyes, heart rhythm disturbances, nasal congestion, bone pain, kidney stones, headache. Löfgren syndrome — enlarged nodes, erythema nodosum, eye symptoms, joint pain, fever; it usually resolves within 2 years (MedlinePlus).

How sarcoidosis is diagnosed

There is no single test: the symptoms resemble other diseases (MedlinePlus). The doctor takes a history and performs an examination: temperature, enlargement of nodes, spleen and liver, auscultation of the chest, skin examination (MedlinePlus).

Examinations: chest X-ray and CT of the lungs. Sometimes the airways are viewed from the inside with a flexible tube with a camera — an endoscope — during which a biopsy of lung tissue is taken. Biopsy is possible from the skin, lymph nodes, and other organs (MedlinePlus). Blood tests show blood counts, hormone levels, and kidney function (MedlinePlus). The course is monitored with repeat X-rays, breathing tests, and laboratory tests.

Possible complications and when to see a doctor

Complications: problems with the lungs, heart, hormonal disorders, damage to the brain, nerves and muscles, kidney problems, severe organ damage (MedlinePlus). In the chronic form, granulomas interfere with organ function: the lungs stop functioning normally, and shortness of breath increases.

If symptoms are present, regular visits to the doctor are needed; if new symptoms appear, you should consult a doctor even if the condition was previously stable (MedlinePlus).

Sarcoidosis itself is not a reason to call an ambulance. 103/112 — in case of sudden deterioration of the condition or another life-threatening situation.

This material is for reference: it does not replace consultation with a doctor.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer