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Sarcoidosis

Overview

Sarcoidosis (pronounced SAR-COY-DOE-SIS) is a disease characterized by the growth of tiny collections of inflammatory cells (granulomas) in any part of your body — most commonly the lungs and lymph nodes. But it can also affect the eyes, skin, heart and other organs.

Cause

The cause of sarcoidosis is unknown, but experts think it results from the body's immune system responding to an unknown substance. Some research suggests that infectious agents, chemicals, dust and a potential abnormal reaction to the body's own proteins (self-proteins) could be responsible for the formation of granulomas in people who are genetically predisposed.

Symptoms & Progression

Although no one can predict how sarcoidosis will progress in an individual patient, some clues as to disease course can be gained from patient symptoms, findings from physical and laboratory studies, and patient race. For example, a sudden onset of general symptoms--such as weight loss, fatigue, fever, or just an overall feeling of ill health--usually means that the course of sarcoidosis will be relatively short and mild in severity. Symptoms of shortness of breath and some types of skin involvement mean that sarcoidosis will be more long-lasting and severe.

In Caucasians, the disease often appears suddenly, which usually indicates a milder form of the disease that is of short duration. African-Americans and Puerto Ricans, on the other hand, tend to develop the more long-term and severe form of the disease.

In the United States, the lungs are often the most common site of initial symptoms for those who experience a gradual onset of their long-term disease. Lung symptoms are common in African-Americans, Puerto Ricans, and Scandinavians. Persistent dry cough, fatigue, and shortness of breath are the most common initial lung-related complaints.

Diagnosis

Sarcoidosis can be difficult to diagnose because the disease often produces few signs and symptoms in its early stages. When symptoms do occur, they may mimic those of other disorders.

Your doctor will likely start with a physical exam and discuss your symptoms. He or she will also listen carefully to your heart and lungs, check your lymph nodes for swelling, and examine any skin lesions.

Diagnostic tests can help exclude other disorders and determine what body systems may be affected by sarcoidosis. Your doctor may recommend tests such as:

Blood and urine tests to assess your overall health and how well your kidneys and liver are functioning
Chest X-ray to check your lungs and heart
Computerized tomography (CT) scan of the chest to check your lungs
Lung (pulmonary) function tests to measure lung volume and how much oxygen your lungs deliver to your blood
Electrocardiogram (ECG or EKG) to detect heart problems and monitor the heart's status
Eye exam to check for vision problems that may be caused by sarcoidosis
Positron emission tomography (PET) scan or magnetic resonance imaging (MRI) if sarcoidosis seems to be affecting your heart or central nervous system

Other tests may be added, if needed.

Treatments

There's no cure for sarcoidosis, but in many cases, it goes away on its own. The severity and extent of your condition will determine whether and what type of treatment is needed. Treatment, when it is needed, generally falls into two categories—maintenance of good health practices and drug treatment.