Sarcoidosis

What Is Sarcoidosis?

Sarcoidosis is an inflammatory disease that causes tiny clumps of immune cells called granulomas to form in one or more organs, most commonly the lungs and lymph nodes. Sarcoidosis is a systemic disease and can also involve other organs like the eye, skin, brain, heart, liver, spleen, kidneys and bones. These granulomas can interfere with how organs function, leading to symptoms that range from mild to life-threatening depending on the severity and the organs affected.

Who Is Affected?

Sarcoidosis can affect anyone, but it’s most commonly diagnosed in adults between ages 20 and 40. It occurs more frequently in women than men and is more prevalent among African American and Scandinavian populations. While sarcoidosis can affect people of all ages and ethnicities, genetic and environmental factors play a role in determining who develops the condition.

What Causes Sarcoidosis?

The exact cause of sarcoidosis is unknown. Researchers believe it may be triggered by an abnormal immune response to an environmental or infectious agent in genetically susceptible individuals. Instead of resolving after fighting off an invader, the immune system stays active, forming granulomas in healthy tissues.

Non-Controllable Risk Factors

• Family history increases risk.
• Race and Ethnicity: Higher prevalence in African Americans, individuals with Scandinavian ancestry, and some Asian groups.
• Age & Sex: Most commonly affects people aged 20–40, with a higher incidence in women.
  
  

Controllable Risk Factors

• Environmental Exposure: Contact with mold, dust, agricultural chemicals, or other irritants may increase the risk.
• Occupational Hazards: Firefighters, healthcare workers, and agricultural workers may have greater exposure to potential triggers.
  
  

Who Is Most at Risk?

• Adults between 20–40 years old
• African American individuals (especially women)
• People with a family history of sarcoidosis
• Those exposed to certain occupational or environmental triggers
  
  

Steps to Reduce Risk

There is no guaranteed way to prevent sarcoidosis, but you can:

• Avoid known lung irritants like tobacco smoke and harmful chemicals
• Maintain a healthy immune system through a balanced lifestyle
• Inform your healthcare provider of any family history or symptoms early

Common Signs & Symptoms of Sarcoidosis

Symptoms can vary depending on the organs involved. Some people may have no symptoms at all, especially in the early stages.

• Lung Symptoms (most common): Dry cough, shortness of breath, wheezing
• General Symptoms: Fatigue, fever, swollen lymph nodes, weight loss
• Skin: Rashes, sores, or discolored patches (often on the shins or face)
• Eyes: Redness, blurred vision, light sensitivity, pain
• Joints and Muscles: Pain, swelling, stiffness
• Heart (in rare cases): Irregular heartbeat, chest pain, or fainting
  
  

Unique Symptoms in Certain Groups

• African American patients are more likely to experience skin involvement and chronic disease.
• Women may experience more fatigue and a higher likelihood of extrapulmonary (non-lung) symptoms.

How Is Sarcoidosis Diagnosed?

Diagnosis can be challenging due to the wide range of symptoms and similarity to other diseases. A combination of tests and medical history is used to rule out other conditions and to confirm the diagnosis of sarcoidosis.

Common Diagnostic Tests

• Chest X-ray or CT scan: To look for granulomas in the lungs or lymph nodes
• Pulmonary Function Tests (PFTs): Assess how well the lungs are working
• Blood Tests: Measure markers of inflammation liver enzymes, kidney function and calcium levels
• Biopsy: Tissue sample confirms the presence of granulomas
• Eye Exam: To check for inflammation even without symptoms
• MRI or EKG: For detecting cardiac sarcoidosis

A multidisciplinary approach may involve pulmonologists, cardiologists, ophthalmologists, neurologists, dermatologists or rheumatologists based on symptoms.

Many people with sarcoidosis don’t require treatment if symptoms are mild or resolve on their own. For others, ongoing treatment is necessary to control symptoms and prevent complications. Sometimes sarcoidosis can lead to irreversible lung fibrosis, which requires proper treatment and follow-up.

Lifestyle

• Quit Smoking
• Regular exercise to help combat fatigue and support lung health
• Healthy diet to reduce inflammation and support immune function
  
  

Medical Treatment

• Corticosteroids (like prednisone): First-line treatment to reduce inflammation
• Immunosuppressive Drugs: For long-term control or steroid-resistant cases (e.g., methotrexate, azathioprine)
• Antimalarial Drugs: Mostly used for skin and joint symptoms (e.g., hydroxychloroquine)

Surgical Options

• Lung or heart transplant: Considered only for severe, end-stage organ failure (very rare)
  
  

Assistive Devices

• Oxygen Therapy: For patients with reduced lung function and whose oxygen levels fall while breathing room air.
• Cardiac Devices: Such as pacemakers in patients with heart involvement
  
  

Other Approaches

• Support Groups and Counseling: Can help manage emotional and psychological stress
• Regular Monitoring: Ensures timely adjustments to treatment

When to Seek Care

When to See Your Doctor

• Persistent cough or chest pain
• Unexplained fatigue, weight loss, or fever
• Changes in vision or eye discomfort
• Rashes, lumps, or unexplained swelling

When to Seek Emergency Medical Care

• Severe shortness of breath
• Chest pain or irregular heartbeat
• Fainting or signs of stroke

Prompt medical attention can prevent complications from affecting the lungs, heart, or other critical organs.