What is Sarcoidosis?

Sarcoidosis is a disease due to inflammation.

The disease can attack any organ of the body in any location. The disease is characterized by the presence of granulomas, small areas of inflamed cells. They can be either inside the body or son the body's exterior, appearing as sores on the face or shins. But sarcoidosis is most frequently found in the lungs.

Pulmonary sarcoidosis can cause loss of lung volume (the amount of air the lungs can hold) and abnormal lung stiffness.

Granulomas can appear on the walls of the alveoli (small air sacs in the lungs) or on the walls of the bronchioles (breathing tubes in the lungs). They also appear in the lymph nodes in the chest, causing them to enlarge.

WHAT CAUSES SARCOIDOSIS?

No one yet knows what causes sarcoidosis.

It is thought by most scientists to be a disorder of the immune system, where the body's natural defense system malfunctions.

Some physicians believe that sarcoidosis may result from a respiratory infection caused by a virus. Others suspect that exposure to toxins or allergens in the environment is to blame. Researchers are looking for answers to this and many other questions about sarcoidosis.

WHAT ARE THE SYMPTOMS OF SARCOIDOSIS?

In pulmonary sarcoidosis, patients may have a dry cough (without sputum), shortness of breath, or mild chest pain.

In those cases where symptoms do appear outside the lung, they can include a scaly rash, red bumps on the legs, fever, soreness of the eyes, and pain and swelling of the ankles.

There can also be more general symptoms like fatigue, weakness, fever, and weight loss. These symptoms are common in many other lung diseases, so diagnosis may be difficult.

HOW IS SARCOIDOSIS DIAGNOSED?

Any of the symptoms listed in the previous section may lead a physician to consider sarcoidosis. Sarcoidosis is initially diagnosed based on a physical examination, laboratory tests, pulmonary function studies, and a chest X-ray. When enlargement of lymph glands in the center of the lungs is seen on X-ray, sarcoidosis may be suspected.

To confirm the diagnosis, a biopsy is usually performed on any of the affected organs or from material in a granuloma on the skin.

HOW SERIOUS IS SARCOIDOSIS?

In over half the cases, sarcoidosis appears briefly and heals naturally. Sometimes the patient doesn't even know or do anything about it. From 20 to 30 percent of pulmonary sarcoidosis patients are left with permanent lung damage. And for a small percentage of patients, their sarcoidosis can become chronic, lasting for many years.

No one can predict how sarcoidosis will affect an individual patient. but several things are certain that may reassure the patient. Sarcoidosis is not contagious. And there is no evidence that it can be inherited, and passed from parents to children.

WHO GETS SARCOIDOSIS?

Sarcoidosis is found throughout the world among almost all races and ages and in both sexes. However, it is most common among African Americans and northern European whites.

Sarcoidosis is mainly a disease of young adults -- patients between the ages of 20 and 40 -- although a few persons past 60 have been known to contract it.

In the United States, a higher percentage of African Americans than whites has sarcoidosis, and the disease is usually more serious in them. The prevalence of sarcoidosis is eight times greater in African Americans than in whites in the U.S.

WHAT BODY SITES DOES SARCOIDOSIS ATTACK?

Ninety percent of the cases of sarcoidosis are found in the lungs.
Other commonly affected Other sites are:

• Skin
• Liver
• Lymph glands
• Spleen
• Eyes
• Nervous system, including the brain
• Musculoskeletal system (the muscles and bones in the body)
• Heart
• Kidneys

WHAT IS THE COMMON COURSE OF SARCOIDOSIS?

In most cases of sarcoidosis that have no symptoms, the disease "burns itself out," disappearing with little or no notice to the patient or physician.

If pulmonary sarcoidosis is serious, it can develop into pulmonary fibrosis (the abnormal formation of fiber-like scar tissue in the lung). This actually distorts the structure of the lungs and can interfere with breathing, especially the ability to exchange oxygen in the lungs.

WHAT IS THE TREATMENT FOR SARCOIDOSIS?

In a majority of patients, the disease spontaneously disappears, and no treatment is necessary.

When therapy is recommended, the main goal is to keep the lungs and other affected body organs working, and to relieve symptoms. Drugs called corticosteroids are the most common treatment used in fighting sarcoidosis.

Some physicians prescribe steroids when there are no symptoms but just abnormalities seen on the chest x-ray and in lung function measurements.

Other physicians wait for symptoms to appear before prescribing corticosteroids.

Frequent check-ups are important so the doctor can monitor the illness and, if necessary, adjust the treatment.

WHAT CAN THE SARCOIDOSIS PATIENT DO?

The sarcoidosis patient should follow his or her doctor's directions. This frequently can be just continuation of a normal lifestyle. When drugs are prescribed, they should be taken faithfully, just as the physician directs.

It is particularly important that sarcoidosis patients do not smoke.

IN SUMMARY

Most people with sarcoidosis can lead a normal life. The sarcoidosis patient should follow his or her doctor's directions. When drugs are prescribed, they should be taken faithfully just as the physician directs.

It is particularly important that sarcoidosis patients do not smoke, and avoid exposure to dust adn chemicals that can harm the lungs.

Even after sarcoidosis heals, and symptoms go away, patients should have a check-up and an eye exam every year.