Sarcoidosis is an inflammatory disease in which clumps of inflammatory cells form in various organs, causing organ inflammation.
Sarcoidosis can happen when your body’s immune system overreacts in its response to foreign substances, such as:
- viruses
- bacteria
- chemicals
This immune response causes cells to form granulomas, or clumps of inflamed tissue, inside affected organs. Over time, this may lead to permanent scarring.
Areas of the body commonly affected by sarcoidosis include:
- lymph nodes
- lungs
- eyes
- skin
- liver
- heart
- spleen
- brain
Some people with sarcoidosis don’t have any symptoms. Symptoms vary depending on the part of your body affected by the disease.
General symptoms may include:
Sarcoidosis can occur in any organ but most commonly affects the lungs. Lung symptoms can include:
- dry cough
- shortness of breath
- wheezing
- chest pain around your breastbone
Skin symptoms can include:
- skin rashes
- skin sores
- hair loss
- raised scars
Nervous system symptoms can include:
Eye symptoms can include:
- dry eyes
- itchy eyes
- eye pain
- vision loss
- a burning sensation in your eyes
- discharge from your eyes
The exact cause of sarcoidosis is unknown.
However, certain factors
- Age: People are more likely to develop sarcoidosis at 55 or older.
- Genetics: People with a family history of sarcoidosis have an increased risk.
- Occupational hazards: Working with mold, insecticides, or other chemical substances that cause inflammation can raise your risk.
- Race and ethnicity: People of African or Scandinavian descent have an increased risk.
- Sex: Females are more likely to develop it.
- Certain medications: Some medications to treat HIV, cancer, or autoimmune diseases can increase your risk.
Doctors typically order lab work and imaging tests to diagnose sarcoidosis.
This can include a physical examination to:
- check for skin bumps or a rash
- look for swollen lymph nodes
- listen to your heart and lungs
- check for an enlarged liver or spleen
Based on the findings, they may order additional diagnostic tests, such as:
- a chest X-ray to check for granulomas and swollen lymph nodes
- a chest CT scan to take cross-sectional pictures of your chest
- a lung function test to determine whether sarcoidosis affects your lung capacity
- a biopsy, or tissue sample of the affected area, to check for granulomas
- blood tests to determine your kidney, liver, and immune function, and an angiotensin-converting enzyme (ACE) blood test, which helps detect or monitor granulomas
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Sarcoidosis can affect any part of the body but commonly impacts the lungs. Doctors typically categorize pulmonary sarcoidosis, or sarcoidosis of the lungs, into four stages.
Staging helps doctors determine how advanced the condition is and which treatments might be right for you.
Doctors assign a stage after a chest X-ray. This imaging test reveals several important factors about how the condition is affecting your lungs.
- Stage 1: Lymph nodes near the heart and lungs are enlarged, but no fluids or substances are in the lungs. A lung tissue biopsy may find granulomas.
- Stage 2: The lymph nodes near the heart and lungs are enlarged, and the lungs contain blood, pus, or proteins.
- Stage 3: Blood, pus, or proteins are present in the lungs, but the lymph nodes are not enlarged or swollen.
- Stage 4: Lungs have pulmonary fibrosis, or damaged or scarred lung tissue that prevents them from working properly and filling up fully with air.
There’s no cure for sarcoidosis.
However, some people do not need treatment, and symptoms often improve without treatment. This is called “spontaneous remission.”
You may need treatment if sarcoidosis affects your:
- eyes
- lungs
- heart
- nervous system
If you need treatment, your doctor may prescribe medications to help suppress the immune system and reduce inflammation. This can ease the symptoms of sarcoidosis. Treatment can depend on how advanced your sarcoidosis is and the symptoms you experience.
Medications for sarcoidosis can include:
- Corticosteroids: Doctors may prescribe prednisone, a steroid, to reduce inflammation. However, steroids can cause severe side effects, so doctors may only prescribe them for a short period.
- Disease-modifying antirheumatic drugs (DMARDs): DMARDs are medications that suppress the immune system. They may slow the progression of sarcoidosis and reduce symptoms. Examples include methotrexate (Trexall), azathioprine (Azasan), and leflunomide (Arava).
- Antimalarial medications: Medications like hydroxychloroquine (Plaquenil) may be helpful for sarcoidosis symptoms that affect the skin and joints.
- Immunotherapy: These medications help stop an overactive immune system. They have significant side effects, so they’re typically reserved for people whose bodies do not tolerate other medications. Examples include rituximab (Rituxan), infliximab (Remicade), and golimumab (Simponi).
- Corticotropin: Doctors may recommend this injected medication to encourage the body to produce natural steroid hormones.
The length of any treatment will vary. Some people take medication for 1 to 2 years. Other people may need to take medication for much longer.
A doctor may also recommend additional medications to help manage your symptoms, such as skin infections or joint pain.
Most people who receive a diagnosis of sarcoidosis don’t experience complications. However, sarcoidosis can become a chronic or long-term condition. Other potential complications may include:
- lung infection
- retinal damage from chronic inflammation
- cataracts, which are characterized by clouding of the lens in your eye
- glaucoma, which is a group of eye diseases that can cause blindness
- kidney failure
- atypical heartbeat
- facial paralysis
- infertility in men or difficulty conceiving due to sarcoidosis affecting the testes
In rare cases, sarcoidosis causes severe heart and lung damage. If this occurs, you may need immunosuppressive medications.
It’s important to contact your doctor if you have any symptoms that may indicate a serious complication. Symptoms can include:
- breathing difficulties
- heart palpitations, which occur when your heart is beating too fast or too slow
- changes in your vision or loss of vision
- eye pain
- sensitivity to light
- facial numbness
The doctor may also recommend seeing an eye doctor, such as an ophthalmologist, as this disease can affect your eyes without causing immediate symptoms.
The outlook is generally good for people with sarcoidosis. Many people live relatively healthy, active lives, and symptoms often improve with or without treatment in about 2 years.
In some cases, however, sarcoidosis can become a long-term condition.
If you need help coping, you can talk with a psychotherapist or join a sarcoidosis support group.
Is sarcoidosis an autoimmune disease?
Some scientists believe sarcoidosis is an autoimmune disease. They think it likely results from the body mistakenly targeting itself instead of foreign bodies like viruses or bacteria.
It often overlaps with other known autoimmune diseases like rheumatoid arthritis and autoimmune thyroid disease.
However, factors like genetics and environmental exposures may trigger the immune response. Researchers have not yet identified
What is the life expectancy for someone with sarcoidosis?
People with asymptomatic sarcoidosis do not usually require treatment. Many remain stable for years without advancing symptoms.
Those who do develop advanced symptoms or complications often have a favorable outlook. Overall, the mortality rate in people who do not get treatment is
The long-term outlook for untreated people can be difficult. Respiratory failure from severe scarring is possible, and it can lead to death.
How does a person get sarcoidosis?
Researchers and doctors do not understand precisely what causes sarcoidosis. It’s also not entirely clear why some people reach remission and never relapse while others progress into advanced stages.
Factors like having specific genes and environmental exposures may impact the development of sarcoidosis.
Sarcoidosis results from an overactive immune system response that causes granulomas to develop. Some people may not have symptoms, but the symptoms a person develops can depend on the part of the body affected.
Treatment typically involves medications to suppress the immune system. While there is no cure for sarcoidosis, some people may experience a complete resolution of the condition. But, for some people, it can develop into a long lasting condition.