Sarcoidosis - Causes, Symptoms, Diagnosis, and Treatment

What Is Sarcoidosis?

Sarcoidosis is characterized by the growth of clumps of inflammatory cells (granuloma), which commonly affects the lungs and lymph nodes. The other organs that can be affected are skin, eyes, and heart. It is believed to be caused by the body's immunity responding to some unknown substance, such as microorganisms, dust, chemicals, and self-proteins (body's own proteins). As of now, there is no cure for this disease, but some cases get better without any medical treatment. Treatment is required when these granulomas damage organs.

What Symptoms Does Sarcoidosis Result In?

Depending on which organ is affected by the formation of granulomas, the signs and symptoms vary.

Common Symptoms:

• Tiredness or fatigue.

• Lymph node enlargement.

• Weight loss.

• Tenderness and inflammation of joints.

The symptoms when granuloma is present in the lungs are:

• Chronic dry cough.

• Shortness of breath or dyspnea.Chest pain.

• Wheezing.

The symptoms when this disease affects the skin are:

• Red or purplish skin rashes on the ankles.

• Large lesions on the nose and cheeks.

• Nodule like skin growth form under the skin.

• Some areas on the skin become darker or lighter.

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The symptoms when granuloma is present in the lungs are:

• Chest pain.

• Dyspnea.

• Syncope.

• Edema.

• Heart arrhythmias.

• Heart palpitations.

The symptoms seen when the eye is affected are:

• Blurry vision.

• Eye pain.

• Eyes become dry and itchy.

• Eye redness.

• Light sensitivity.

Sometimes, sarcoidosis progresses gradually and the symptoms last for years, while some cases result in sudden symptoms, which disappear on their own. And sometimes for patients with no symptoms, sarcoidosis is diagnosed during a routine chest X-ray. This disease can also affect the nervous system, liver, spleen, calcium metabolism, and bones.

What Can Cause Sarcoidosis?

Sarcoidosis is believed to be affected by genetics, but the exact cause is not known. People who have a genetic predisposition, develop this disease when triggered by infections caused by microorganisms, chemicals, or dust.

These triggers make the immune system overreactive, which results in the collection of inflammatory and immune cells called granulomas. These granulomas can buildup in any organ and can affect its functioning.

Risk Factors:

The risk factors for sarcoidosis are:

• Women are more prone.

• People between the ages of 20 and 60 years,

• Africans, Northern Europeans, and African-Americans are more susceptible.

• A positive family history.

When to Consult a Doctor?

If you experience the following symptoms, it is best you consult a doctor immediately:

• If your breathing becomes labored.

• If your heart is beating too fast.

• If you have problems with your vision.

• If your eyes are paining.

• If you develop facial numbness.

• If you become sensitive to light.

How Does a Doctor Diagnose Sarcoidosis?

It is difficult to diagnose sarcoidosis in the early stages, as it does not usually cause any symptoms. And as the symptoms are not specific to this disease, it is often misdiagnosed.

The doctor will first perform a physical examination, listen to your heart and lungs sounds, and check if the lymph nodes are enlarged. To rule out all possible causes for your symptoms, your doctor might suggest you get the following tests done:

• Blood and urine tests - Kidney and liver function tests are done to check how well your organs are functioning.

• Imaging tests (Chest X-ray, CT scan) - To see how your heart and lungs are.

• Lung function tests - To check how efficiently your lungs are working.

• Electrocardiogram (ECG) - To monitor your heart.

• Eye examination - To check your vision.

• Magnetic resonance imaging (MRI) - To see if there are granulomas on the heart, brain, or spinal cord.

• Biopsies - If any imaging test shows lesions or granulomas or if you have skin lesions, then the doctor might take a biopsy from the affected areas to check for cells in the granulomas.

What Are the Treatment Options for Sarcoidosis?

There is no known cure for sarcoidosis, but in some patients, the symptoms go away without any treatment. If you are experiencing symptoms, then your doctor will prescribe medicines to relieve those symptoms and to help the affected organ function properly. The treatment options include:

Medications:

• Corticosteroids - This helps in reducing inflammation.

• Immunosuppressants - Medicines like Methotrexate and Azathioprine are used to suppress the action of the immune system.

• Hydroxychloroquine - To treat high blood calcium levels.

• Tumor necrosis factor-alpha (TNF-alpha) inhibitors - The drugs of this group are prescribed when no other treatment option has worked.

Other Treatments:

• Physiotherapy - To improve muscle strength.

• Pulmonary rehabilitation - To relieve breathing problems.

• Cardiac pacemaker - To correct arrhythmias.

• Organ transplantation - It is only done if the organ, such as lungs, heart or liver, is severely damaged.

Lifestyle Changes:

• Go for regular follow-ups.

• Never skip your medicines or stop them without consulting your doctor.

• Eat healthily.

• Maintain a healthy weight.

• Reduce stress.

• Exercise regularly.

• And sleep at least for 7 hours every day.

What Are the Complications of Sarcoidosis?

In some patients, sarcoidosis can result in the following chronic complications:

1. Pulmonary fibrosis - If left untreated, sarcoidosis of the lungs can cause permanent scarring of the lungs or pulmonary fibrosis. It results in breathing problems and pulmonary hypertension.

2. Eye problems - Sarcoidosis affecting the eye can damage the retina and cause blindness, or it can also result in cataracts and glaucoma.

3. Heart problems - Sarcoidosis of the heart can cause arrhythmias and abnormal heart function.

4. Kidney diseases - As sarcoidosis affects calcium metabolism, it can cause kidney stones and affect kidney function.

5. Central nervous system problems - When granuloma affects the brain or spinal cord, it can cause permanent nerve damage and paralysis.

6. Infertility.

If you have been diagnosed with sarcoidosis, it is important that you consult a doctor regularly, even if your symptoms are getting better. Even if the doctor advised no medical treatment, you have to keep monitoring your condition with regular tests. With proper treatment, most patients lead an almost active and healthy life. The symptoms take about a couple of years to improve, with or without treatment. But in rare cases, this condition can become chronic. For any doubts about sarcoidosis, consult a doctor now.