Sarcoidosis: Cause, Symptoms, Diagnosis and Treatment

Sarcoidosis is an inflammatory disorder that causes the formation of granulomas - collections of inflammatory cells - in any part of the patient's body. The most commonly affected organs are the lungs, skin, and lymph nodes; but any organ in the body can be affected. There are 1.2 million sarcoidosis patients worldwide and among those, 5-10% have advanced sarcoidosis. Lungs are affected in 90% of all cases.

The exact cause of sarcoidosis is still unknown. The current working theory claims that it occurs because of an altered immune response after exposure to a triggering environmental agent in genetically predisposed people. 

What are the symptoms?

Sarcoidosis symptoms differ based on which organ of the body the disorder affects, but there are some general symptoms:

  • fatigue
  • lack of energy
  • weight loss
  • joint aches
  • arthritis
  • knee swelling
  • dry eyes and blurry vision
  • skin lesions 
  • dry cough

If the disorder is affecting the respiratory tract (pulmonary sarcoidosis), the following symptoms can be observed:

  • shortness of breath that gets worse when the patient is active
  • a persistent dry cough
  • chest pains
  • wheezing

In some rare cases, pulmonary sarcoidosis can cause the lung tissues to get inflamed and become scarred and stiff. This is called pulmonary fibrosis, it can change the structure of the organ and affect breathing patterns. 

Another rare occurrence is the formation of pockets in the air tubes of the lungs, which then become infected. This is called bronchiectasis.

World Sarcoidosis Day April 13-blog-1

Sarcoidosis diagnosis

Sarcoidosis is usually diagnosed when other lung disorders are ruled out, it is a matter of exclusion because there is no specific test for the condition.

After learning the complete medical history and administering a physical exam, these tools may be used in order to make a diagnosis:

  • chest x-ray
  • CT scan
  • pulmonary function tests
  • blood tests
  • bronchoscopy
  • bronchoalveolar lavage
  • lung biopsy

Sarcoidosis treatment

In most cases, there is no treatment needed as the disease goes away on its own. 

For patients with persistent sarcoidosis, medical treatment can be used to control symptoms and prevent complications. Generally, treatment is advised when the quality of life of the patient is severely affected or there is a risk of organ damage or death. 

The treatment process often occurs with the help of a multidisciplinary team of health care professionals, because the disease can affect many organ systems. 

The medications prescribed can be in one of the following groups:

  • corticosteroids: this treatment is used to reduce inflammation and generally relieves symptoms in a few months.
  • immune system suppressants: sarcoidosis may be the result of an immune system overreaction. So, if corticosteroids are ineffective, suppressing the immune system may make the symptoms less severe and protect the organs from any further damage.
  • antimalarial drugs: the original use of these drugs is in the treatment of malaria, but they are also effective in the cases where there are skin symptoms. 

It is also recommended that patients stop smoking, avoid exposure to irritants such as chemicals, fumes, and toxic gases, follow a healthy diet and drink plenty of water. 

Sources

  1. "Sarcoidosis", National Health Service, 2018.
  2. "Sarcoidosis", Mayo Clinic, 2019.
  3. "Pulmonary Sarcoidosis", John Hopkins Medicine. 
  4. "Sarcoidosis in America", American Thoracic Society, 2016.
  5. "Global burden of chronic pulmonary aspergillosis complicating sarcoidosis", European Respiratory Society, 2012. 
  6. "A Case Controlled Etiologic Study of Sarcoidosis", American Thoracic Society, 2006.

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