Sarcoidosis: Causes, symptoms, and treatment
Date: Jun-27-2017 Sarcoidosis is a condition involving the growth of persistent or inappropriate granulomas or clumps of inflammatory cells. But what causes them and how can they be treated?
While sarcoidosis can occur in any organ, an estimated 90 percent of cases involve the lungs.
Currently, there is no cure for sarcoidosis, although some cases resolve without medical intervention.
Granulomas can damage organs and may require treatment. This may be the case if they begin to take up a significant portion of an organ or persist for a long time.
This article looks at the causes and symptoms of sarcoidosis and explores how they may be treated.
Contents of this article:
What is sarcoidosis?
Risk factors
Symptoms
Diagnosis
Treatment and outlook
What is sarcoidosis?
While sarcoidosis can occur in any organ, it occurs most commonly in the lungs.
Sarcoidosis is a chronic inflammatory condition that leads to the formation of persistent granulomas or clumps of inflammatory cells.
Granulomas are formed as a normal part of the immune response, but they typically break up after foreign objects or irritants have been expelled.
Sarcoidosis involves the development of granulomas that form or linger when they are no longer needed.
Researchers are still not sure why or how sarcoidosis occurs. However, it may be the result of an excessive immune response to an irritant or allergens, such as:
viruses
bacteria
pollution
dust
chemicals
There is some evidence to suggest certain individuals may be more genetically predisposed to develop the condition.
The bulk of sarcoidosis cases involve or begin in the lungs. The lymph nodes and glands, especially those surrounding the lungs, are also impacted. However, sarcoidosis can affect any organ in the body.
Though less common, cases involving organs, such as the heart, brain, and kidneys, are often far more severe. Also, they can be difficult to treat and may cause serious health complications.
Risk factors
An estimated 10-15 in 100,000 Americans develop sarcoidosis annually.
However, the actual risk of developing the condition varies, largely depending on individual factors. These include:
Race and/or ethnicity: Rates of sarcoidosis among African-Americans are estimated to be three to four times higher than white people.
Age: Sarcoidosis most commonly impacts those between 20 and 40 years of age.
Sex: As with most inflammatory conditions, women are considered at greater risk of developing sarcoidosis, especially over the age of 50.
Family history: Those who have family members who have had sarcoidosis are at a greater risk of developing the condition.
Further research is needed to better understand the association between race and ethnicity and sarcoidosis.
Symptoms
The symptoms associated with sarcoidosis can differ drastically between individuals.
Symptoms also vary greatly depending on the location of granulomas and the size of the organ involved.
In acute sarcoidosis, symptoms are present for less than 2 years, and half of those affected by them will have no symptoms after that.
In chronic cases, symptoms progress, linger or recur for weeks or years. The concern with chronic sarcoidosis is the progression from the granulomas to fibrosis in organs, such as in the lungs.
Noticeable symptoms only occur when granulomas have become invasive, accounting for a sizeable portion of the organ they are in. The development of symptoms also means that granulomas begin to impede or lessen the functioning of the organ.
Some of the signs and symptoms of sarcoidosis include:
fever
exhaustion
pain in the joints
weight loss
depression
cough
shortness of breath
wheezing
abnormal heartbeat
abnormal sweating
Rashes can also develop on the lower extremities, such as ankles and shins, or on the upper body.
More specific signs may indicate which organ is involved. Symptoms associated with sarcoidosis in specific organs are detailed below.
Lungs
Symptoms of sarcoidosis in the lungs include:
chronic dry cough
wheezing
shallow breath or dyspnea - a shortness of breath or trouble catching the breath
unidentifiable chest pain, often radiating out
Lymph nodes
Symptoms include a sore throat and swollen lymph nodes.
Symptoms of sarcoidosis in the lymphatic system include:
swelling or edema, excess buildup of fluid
pain
redness
difficulty swallowing
sore throat
general exhaustion or discomfort
Heart
Symptoms of sarcoidosis in the heart include:
pain, often radiating throughout the chest
feeling faint or fainting
unexplained exhaustion
palpitations with rapid, fluttering heart beat
arrhythmias or irregular heartbeat
edema or swelling caused by the build up of fluid
dyspnea or shortness of breath and/or difficulty catching breath
Eyes
Cases of sarcoidosis that impact the eyes do not often cause symptoms. This means many go undiagnosed until permanent damage has been done.
When present, the symptoms of sarcoidosis of the eye include:
pain or soreness
redness
sensitivity to light
blurred or cloudy vision
Nervous System
Symptoms of sarcoidosis of the nervous system include:
facial paralysis or loss of muscle control
inflammation in the brain, leading to seizures and other changes
meningitis symptoms, such as headache and neck stiffness
damage to small nerves
Skin
Symptoms of sarcoidosis of the skin include:
erythema nodosum, which is a raised red rash on the shins and ankles, often warm and tender to touch
nodules or growths under the skin, especially around scar tissue
skin discoloration, where some regions become lighter or darker than normal
lesions or sores, leading to permanent skin damage and disfigurement, often on the cheeks, nose, and ears
Joints, connective tissues, bones, and muscles
Sarcoidosis can cause arthritis and loss of flexibility.
Symptoms include:
arthritis
loss of muscle control, tone, or function
loss of flexibility, ease, or range of motion
generalized joint pain
generalized weakness and exhaustion
Diagnosis
Recognizing the signs of sarcoidosis can be difficult.
Some 90 percent of all cases are not significant enough for doctors to be able to diagnose them. They may also be undetectable by radiographic devices.
Diagnoses are often made during examinations or testing for other health conditions, for example, chest X-rays for:
pneumonia
injury
lung cancer
If sarcoidosis is suspected, a doctor will begin by examining the impacted area and reviewing a person's medical history.
Additional tests used to diagnose sarcoidosis include:
computerized tomography (CT) scan
positron emission tomography (PET) scan
chest X-ray to assess lymph node involvement and lung damage
lung function tests to assess lung volume or blood flow and associated oxygen delivery
examinations of the eyes
blood tests to assess organ function or change, in particular, measuring kidney enzymes and markers
biopsies of organ tissues
Treatment and outlook
Anti-inflammatory medications can help reduce the symptoms of sarcoidosis.
In approximately half of all sarcoidosis cases, symptoms resolve or go away on their own.
More severe or persistent symptoms benefit from medical treatment. Though there is currently no cure for sarcoidosis, therapeutic options exist to treat the symptoms.
Some of the medications and therapeutic options available include:
anti-inflammatory, topical or oral corticosteriods
immunosuppressants
surgery
hydroxychloroquine (Plaquenil)
tumor necrosis factor-alpha (TNF-alpha)
Complications
It is important that sarcoidosis is treated correctly as complications associated with long-term cases can include:
heart conditions
blindness
breathing difficulties
kidney damage or failure
muscle paralysis
skin disfiguration and discoloration
Written by Jennifer Huizen
Courtesy: Medical News Today
Note: Any medical information available in this news section is not intended as a substitute for informed medical
advice and you should not take any action before consulting with a health care professional.