Sarcoidosis

What Is Sarcoidosis?

Sarcoidosis is a multi-organ system disease with no known cause. It commonly affects the lungs, skin, eye and lymph nodes where the abnormal tissue development is seen in multiple areas.

In U.S., the disease is commonly seen in the African- American women and between the ages of 20 and 40. There have also been cases affecting the elderly and children as well. The number of cases in the U.S. is estimated to be 10 to 40 per 100,000 people.

How Does It Occur?

Although the triggers for sarcoidosis are not yet known, scientists have figured out that the disease process is a result of abnormal white blood cell activation leading to a formation of granulomas in the tissues.

Granulomas are mostly collections of white blood cells and epithelial cells (cells that cover organ surfaces). When enough granulomas are formed within an organ, they may alter the normal architecture of the organ, causing the organ to function improperly.

What Are The Symptoms?

The symptoms of sarcoidosis are non-specific and will vary depending upon which part of the body is affected. The lung is the most commonly affected organ so respiratory symptoms such as cough, shortness of breath and a feeling of discomfort behind the sternum are widely seen.

Other symptoms include:

General: Fever, fatigue, anorexia, weight loss;
Skin: Reddish raised bumps (especially on the shins and can be quite painful), bumps underneath the skin;
Eye: Blindness, tearing, reddish eye;
Joints: Arthritis symptoms

How Is It Diagnosed?

Sarcoidosis is a difficult disease to diagnose. Symptoms and routine physical exams usually give rise to the suspicion of sarcoidosis.

The following test helps to diagnose the disease:

Diagnosis of sarcoidosis is confirmed by a biopsy of the suspected granuloma, which is examined under the microscope. Common biopsy sites are the lungs and the lymph nodes. Chest X-ray and CT scans aid the doctor in locating the area of biopsy.

Sarcoidosis is diagnosed only when the symptoms are consistent with a positive biopsy for the granuloma.

How Is It Treated?

The major problem in treating sarcoidosis is deciding when to treat, given that about 50 percent of cases will clear spontaneously.

For mild symptoms of sarcoidosis, it's reasonable not to begin any medical therapy.

However, patients normally visit a doctor about their symptoms because they are severe enough to affect their normal activities. Glucocorticoids therapy is the treatment of choice. Other medications that may also be used are indomethacin, chloroquine, methotrexate and allopurinol.

Prognosis for the disease is relatively good. Approximately 15 to 20 percent of patients will have chronic active disease.

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