Sarcoidosis

What is sarcoidosis?

From: MedlinePlus, National Library of Medicine

Sarcoidosis is a condition in which groups of cells in your immune system form small, red, and swollen (inflamed) lumps. These lumps are called granulomas. They can form in any organ in the body. But they most commonly affect the lungs and lymph nodes in the chest. Over time, sarcoidosis can cause permanent scarring of organs.

What causes sarcoidosis?

From: MedlinePlus, National Library of Medicine

Your immune system creates inflammation to help defend you against germs and sickness. But in sarcoidosis, inflammation goes off track. It causes the cells in your immune system to form granulomas. Studies suggest that this inflammation might be triggered by infections and certain substances in the environment such as insecticides and mold. And your genes may affect how your immune system reacts to a trigger.

Who is more likely to develop sarcoidosis?

From: MedlinePlus, National Library of Medicine

Anyone can develop sarcoidosis, but you are more likely to have it if you:

• Are older, especially if you are over age 55
• Live or work near insecticides, mold, or other substances that may cause inflammation
• Have a close relative who has sarcoidosis
• Take certain medicines, such as some types of HIV medicines and monoclonal antibodies
• Are of African or Scandinavian descent
• Are female

What are the symptoms of sarcoidosis?

From: MedlinePlus, National Library of Medicine

Many people who have sarcoidosis have no symptoms, or they may feel unwell but without any obvious symptoms. If you have symptoms, you may have some general symptoms. And you may have other symptoms, which will depend upon which part of the body is affected.

The general symptoms can include:

The symptoms of sarcoidosis in the lungs can include:

The symptoms of sarcoidosis in other parts of the body can include:

There is also a set of symptoms that are called Lofgren's syndrome. Some people have Lofgren's syndrome when they first develop sarcoidosis. It usually goes away completely within 2 years. The symptoms of Lofgren's syndrome may include:

• Fatigue
• Weight loss
• Swollen lymph nodes
• Depression
• Fever
• Night sweats (heavy sweating during sleep)
• Wheezing
• Cough
• Shortness of breath
• Chest pain
• Larger than normal liver or spleen
• Jaundice, which can make your eyes or skin yellow
• Nervous system problems, such as: Headache Dizziness Vision problems Seizures Numbness or tingling
• Heart palpitations or an irregular heartbeat (arrhythmia)
• Pain and swelling in the joints
• Skin problems such as rashes and growths under the skin
• Swollen lymph nodes in your chest, neck, chin, armpits, or groin.
• A rash of small, itchy, or painful bumps called erythema nodosum. The rash is most often on your head, neck, or legs.
• Blurred vision, eye pain or redness, light sensitivity, or watery eyes.
• Joint pain, stiffness, or swelling.
• Fever.

What other problems can sarcoidosis cause?

From: MedlinePlus, National Library of Medicine

If untreated, or if the treatment does not work, sarcoidosis can cause serious health problems called complications. Possible complications include:

• Lung problems
• Heart problems
• Hormone problems
• Brain, nerve, or muscle problems
• Kidney problems
• Severe organ damage

How is sarcoidosis diagnosed?

From: MedlinePlus, National Library of Medicine

There is no single test that can diagnose sarcoidosis, and its symptoms can be similar to the symptoms of many other conditions. That makes it hard to diagnose. To find out if you have sarcoidosis, your health care provider:

• Will ask about your medical history, including your symptoms, lifestyle, and any other health conditions you may have.
• Will do a physical exam, which may include: Checking your temperature Checking to see if your lymph nodes, spleen, or liver are swollen Listening to your chest with a stethoscope as you breathe in and out Looking for rashes or sores on your body, such as scalp and lower legs
• Will likely order various tests, such as: Chest x-rays A biopsy of the skin, lymph nodes, lungs, or other affected organs Blood tests to check your blood counts, hormone levels, and how well your kidneys are working Other imaging tests

If you are diagnosed with sarcoidosis, your provider may order other tests to look at how sarcoidosis is affecting the body.

What are the treatments for sarcoidosis?

From: MedlinePlus, National Library of Medicine

There is no cure for sarcoidosis. The goal of treatment for sarcoidosis is remission, which means you still have the condition, but it does not cause you problems.

You may not need treatment, and sometimes the condition goes away on its own. If you do need treatment, which treatment(s) you get will depend on your symptoms, which organs are affected, and whether those organs are working well. You may be given medicines to:

• Lower inflammation
• Treat an overactive immune response
• Treat joint pain
• Treat skin problems

If you have complications from sarcoidosis, you may need other treatments, such as other medicines, surgery, oxygen therapy, pulmonary rehabilitation, or an implanted cardiac pacemaker or defibrillator.

Whether or not you have symptoms from sarcoidosis, it's important to get regular follow-up care from your provider, make healthy lifestyle changes, and contact your provider if you have any new symptoms.

Which doctor should you see?

The suggested department for discussing Sarcoidosis is Rheumatology, with a rheumatologist as the relevant type of clinician. General physician / Family Medicine; paediatrician for children. Referral depends on symptoms.

Additional services that may be relevant, depending on the findings, include: Clinical Genetics.

This is an editorial referral starting point. The appropriate clinic depends on the person’s age, symptoms, previous diagnosis and local services. The first clinician can decide whether another specialty or a team is needed; a department label does not confirm the diagnosis.

How to prepare for an assessment

Bring a short timeline of the main symptoms: when they first appeared, whether they are constant or episodic, what seems to change them, and how they affect daily activities. Include previous reports, discharge summaries, current medicines and supplements, allergies, and any relevant family history. A dated record is more useful than trying to match every feature in an online article.

Ask the clinician what is already established and what remains uncertain. If a test is suggested, ask what question it answers, what its limitations are and how the result would change the next step. The information here is not an instruction to arrange every possible test. In children, bring growth, developmental and school information if it is relevant to the concern.

• Are the findings inflammatory, structural or due to another mechanism?
• Is there evidence that other organs need assessment?
• How will function and any treatment-related risks be monitored?

Treatment discussions and follow-up

Where the source describes treatments, these are an overview of possible care, not a prescription for an individual. Ask which option applies to the confirmed diagnosis, what benefit is expected, what adverse effects to watch for and how progress will be assessed. Availability, approvals and local practice can differ from the country described in the source.

Before leaving the appointment, clarify the next review date, who will communicate results, and whom to contact if the situation changes. Discuss difficulties with sleep, work, school, mobility, eating or emotional wellbeing when these are relevant. Practical support may require coordination between the treating clinician and other services.

The collected references do not establish a complete prevention or long-term outlook section for this entry. Missing information should not be interpreted as proof that prevention is impossible or that a particular outcome is inevitable. Ask what is known for the exact subtype, stage and personal circumstances, and which uncertainties remain.

When to seek emergency help

Severe breathing difficulty, collapse, new stroke-like symptoms, a seizure that is prolonged or repeated without recovery, uncontrolled major bleeding, or an immediate risk of self-harm require emergency help. In India, call 112 or reach the nearest emergency department. This is a general, non-exhaustive warning list; it is not a condition-specific triage tool.