Sarcoidosis - symptoms and treatment
Sarcoidosis - An inflammatory disorder in which multiple granulomas (nodules of hardened LYMPH and fibrous tissues) form in organs and tissues throughout the body. Sarcoidosis most commonly affects the LUNGS, LIVER, lymph nodes, eyes, and SKIN, though can affect any body structure. The granulomas typically have alternating growth and REMISSION stages, though generally cause permanent scarring. Though most people who have sarcoidosis develop small granulomas and have mild symptoms, sarcoidosis can be severe when the granulomas clump together to form large enough lesions to interfere with an organ’s functions. Sarcoidosis that affects the HEART can cause lifethreatening ARRHYTHMIA with high risk for SUDDEN CARDIAC DEATH.
Symptoms of Sarcoidosis and Diagnostic Path
Most often sarcoidosis begins in the lungs, causing pulmonary symptoms, and in the lymph nodes. Symptoms are specific for the organ system involved. Generalized symptoms may include
- fatigue, weakness, and malaise (general sense of not feeling well)
- weight loss and loss of APPETITE
- FEVER
- night sweats and sleep disturbances
- SPLENOMEGALY (enlarged SPLEEN)
- HEPATOMEGALY (enlarged liver)
- enlarged, tender lymph nodes
- HEADACHE
- ERYTHEMA NODOSUM (red, painful skin lesions most commonly appearing on the shins)
The diagnostic path begins with BLOOD tests, chest X-RAY, and pulmonary function tests (95 percent of people who have sarcoidosis have lung involvement). The doctor may conduct other diagnostic procedures, depending on the symptoms and the necessity to rule out other causes for them. Though various procedures can show characteristic evidence of sarcoidosis, there are no conclusive diagnostic tests for sarcoidosis. Imaging procedures such as COMPUTED TOMOGRAPHY (CT) SCAN and MAGNETIC RESONANCE IMAGING (MRI) can reveal the extent of damage present as a consequence of the granulomas.
Sarcoidosis Treatment Options and Outlook
Long-term treatment (up to a year) with CORTICOSTEROID MEDICATIONS reduces the INFLAMMATION that causes symptoms and mitigates the consequential damage. Topical medications can improve skin symptoms. Severe or resistant symptoms may require IMMUNOSUPPRESSIVE THERAPY or IMMUNOTHERAPY. Even with treatment, sarcoidosis remains a chronic condition with alternating periods of remission (no symptoms) and exacerbation (resumed or intensified symptoms).
| MEDICATIONS TO TREAT SARCOIDOSIS | |
|---|---|
| azathioprine | cyclophosphamide |
| etanercept | hydroxychloroquine |
| infliximab | methotrexate |
| pentoxifylline | prednisone |
| tetracycline | thalidomide |
Risk Factors and Preventive Measures
There are no clear risk factors for sarcoidosis, though it is more common and often more severe in African American women. Nor are there any known measures to prevent sarcoidosis from developing. Researchers believe many people have undetected sarcoidosis, making this inflammatory disorder far more common than doctors have long believed. Early diagnosis and treatment can minimize the consequences of the inflammation and fibrosis and allow improved QUALITY OF LIFE.
See also AUTOIMMUNE DISORDERS; EYE; GRANULOMA; IMMUNE DISORDERS; LIVING WITH IMMUNE DISORDERS; LYMPH NODE; OFF-LABEL USE; SCAR.
