Southeast Lung Associates – SARCOIDOSIS
For the physician who is working on the scientific frontier, the disease can be a fascinating challenge. For the patient, it can be a very serious illness – even fatal – or it can be of little consequence.
Many sarcoidosis patients do not even have any symptoms and probably never know they have the disease.
Sarcoidosis is not contagious.
The disease can attack any organ of the body in any location, but it is most frequently found in the lungs. Pulmonary sarcoidosis can cause loss of lung volume and abnormal lung stiffness.
The disease is characterized by the presence of granulomas, small areas of inflamed cells. They can be either inside the body or on the body’s exterior. They can appear on the walls of the alveoli (small air sacs in the lungs) or on the walls of the bronchioles (breathing tubes into the lungs). These granulomatous lesions can also appear as sores on the face or shins.
How serious is sarcoidosis?
Approximately 10,000 cases are found in the U.S. annually. (Many more probably occur but are not found). Two-thirds of the patients who have sarcoidosis recover completely. In only 3% is the disease fatal. In between the two extremes, patients have mild to severe sarcoidosis with various degrees of impairment – or none at all.
Who gets sarcoidosis?
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 have it. More women in the child-bearing years get sarcoidosis than persons in other population groupings.
A higher percentage of blacks than whites have sarcoidosis and the disease is usually more serious in blacks. Young black women have sarcoidosis 10 to 15 times more often than the general population.
What causes sarcoidosis?
This is a big part of the mystery. No one knows. The causes put forth at various times have been imaginative to say the least. For instance, pine pollen, spray deodorants, or broken fluorescent light bulbs. None have stood the test of time and analysis.
Some physicians believe sarcoidosis results from inhalations of an infectious or allergic substance from the environment. Whatever the case, it is fairly well accepted that granuloma formation is the result of the body’s effort to localize, and eventually destroy, an invading agent.
What are the symptoms of sarcoidosis?
Most sarcoidosis patients have no symptoms at all. In those cases where symptoms do appear, they can include a scaly rash, red bumps on the legs, fever, soreness of the eyes, and pain and swelling of the ankles. In pulmonary sarcoidosis, patients occasionally have a dry cough (without sputum) and some breathlessness. Rarely is the breathlessness severe at the onset. There also can be fatigue, weakness, 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 the physician to consider sarcoidosis.
Sarcoidosis is also frequently found, almost by chance, by a chest x-ray. When enlargement of lymph glands in the center of both lungs is seen, sarcoidosis may be suspected. A biopsy is usually performed on any of the affected organs or from material in a granuloma on the skin.
What body sites does sarcoidosis attack?
Ninety percent of the cases of sarcoidosis are found in the lungs. Other sites are:
- Heart
- Musculoskeletal system
- Nervous system – brain – spinal cord
- Kidneys
- Eyes
- Skin
What is the common course of sarcoidosis?
Because most cases of sarcoidosis have no symptoms, the disease usually “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 fiberlike scar tissue). This actually distorts the architecture of the lungs and can interfere with breathing. Bronchiectasis can develop. This is a lung disease in which pockets form in the air tubes of the lung and become sites for infection.
What is the treatment for sarcoidosis?
In a majority of patients, the disease spontaneously disappears, and no treatment is necessary. Corticosteroids are the most important drugs used in fighting sarcoidosis. Some physicians prescribe steroids when there are no symptoms but just abnormalities seen on the chest x-ray or in lung function measurements. Other physicians wait for symptoms to appear before prescribing corticosteroids. Sometimes the drugs are prescribed every day; at other times on alternate days.
What can the sarcoidosis patient do?
The sarcoidosis patient should follow his or her doctor’s directions. This can frequently be just continuation of a normal lifestyle. When drugs are prescribed, they should be taken faithfully, just as the physician directs. No one should smoke cigarettes. It is particularly important that sarcoidosis patients not smoke.