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The exact cause of sarcoidosis is unknown
Sarcoidosis is a rare condition that causes small patches of red and swollen tissue (granulomas) in the organs of the body. It usually affects the lungs and skin. This condition may change the normal structure and possibly the function of an affected organ.
Siltzbach developed the staging of sarcoidosis based on radiographic findings:
- Stage 0: Normal appearance in chest radiography. In some cases, red and swollen tissue is noted in the lymph nodes. A normal chest X-ray does not exclude the diagnosis of sarcoidosis, particularly when cardiac or neurologic involvement is suspected. Computed tomography (CT) of the chest may be helpful.
- Stage I: Lymphadenopathy (enlarged lymph nodes)
- Stage II: Enlarged lymph nodes with shadows on chest X-ray due to lung infiltrates or granulomas
- Stage III: Chest X-ray shows lung infiltrates as shadows, which is a progressive condition.
- Stage IV (Endstage): Pulmonary fibrosis or scar-like tissue found on a chest X-ray. Chest X-ray usually demonstrates a honeycomb-like appearance in the lungs. Due to this scar-like tissue or honeycomb-like appearance, patients may have difficulty breathing. It is permanent damage.
What are the causes of sarcoidosis?
The exact cause of sarcoidosis is unknown; however, research shows that having certain inherited genes make it more likely for a person to develop sarcoidosis. A person with a close blood relative who has sarcoidosis is nearly five times as likely to develop the condition.
Sarcoidosis is a result of an abnormal immune system, where the body starts to attack its tissues and organs. The resulting swelling then causes granulomas to develop in the organs. Some possible triggers include:
- Environmental factor or allergies
- Exposure to viruses, fungi, or bacteria
- Exposure to chemicals
- Patients who had recent organ transplantation
It is most common among adults between the ages of 20 and 40 years. The disease is slightly more common in women than in men. The disease is 10 to 17 times more common in African Americans than in Caucasians. People of Scandinavian, German, Irish, or Puerto Rican origin are also more prone to the disease. The condition is not infectious, so it cannot be passed from person to person.
What are the symptoms of sarcoidosis?
Many people with sarcoidosis do not have any symptoms. Others have only vague symptoms that include:
- Reddish tender bumps or patches on the skin
- Red and teary eyes or blurred vision
- Swollen and painful joints
- Enlarged and tender lymph glands in the neck, armpits, and groin
- Enlarged lymph glands in the chest and around the lungs
- Hoarse voice
- Pain in the hands, feet, or other bony areas due to the formation of cysts (an abnormal sac-like growth) in bones
- Weakness
- Weight loss
- Dry cough and shortness of breath
- Kidney stone formation
- Enlarged liver
- Arrhythmias (irregular heartbeat), pericarditis (inflammation of the covering of the heart), or heart failure
- Nervous system effects including hearing loss, meningitis, seizures, or psychiatric disorders (for example, dementia, depression, and psychosis)
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What are the treatment options for sarcoidosis?
There is no cure for sarcoidosis, but the disease may get better on its own over time. Sarcoidosis symptoms will often get better without treatment. Treatment is aimed at maintaining good lung function, reducing symptoms, and preventing organ damage:
Nonsteroidal anti-inflammatory drugs (NSAIDs): These may be used to treat pain, swelling, and discomfort.
Corticosteroids: Prednisone is the choice of treatment in symptomatic patients. Inhaled corticosteroids may relieve cough and upper respiratory discomfort. Topical corticosteroids may be useful in dermatologic conditions.
Immunosuppressants: They are usually given to patients who cannot tolerate prednisone; however, in a few conditions, they may be given in combination with other drugs. Methotrexate is the most commonly used immunosuppressant. Other immunosuppressants include hydroxychloroquine, azathioprine, mycophenolate mofetil, cyclophosphamide, leflunomide, and infliximab. Relapse is usually common after stopping an immunosuppressant.
Organ transplantation: It is an option for patients with end-stage pulmonary, cardiac, or liver involvement, although the disease may recur in the transplanted organ.
Lifestyle modifications: These include:
- Eating a well-balanced diet with various fresh fruits and vegetables
- Drinking enough fluids every day
- Getting six to eight hours of sleep each night
- Exercising regularly and managing your weight
- Quitting smoking
- Avoiding exposure to dust, chemicals, fumes, gases, toxic inhalants, and other substances that can harm your lungs
- Avoiding excessive amounts of calcium-rich foods (such as dairy products, oranges, and canned salmon with bones), vitamin D, and sunlight