Sarcoidosis

Overview

Sarcoidosis is a condition that causes tiny collections of immune system cells in any part of the body. These tiny collections form red, swollen lumps called granulomas. Granulomas most commonly occur in the lungs and the lymph nodes of the chest. They also can occur in the eyes, skin, heart and other organs.

Experts don't know the exact cause of sarcoidosis, but it's likely a mix of genetic and environmental factors. Some people appear to have gene changes that make them more likely to develop sarcoidosis. The condition may then be triggered by bacteria, viruses, dust or chemicals. Their immune system overreacts to the trigger, causing inflammation that forms granulomas.

There is no cure for sarcoidosis, but most people do not need treatment. Sarcoidosis may go away on its own. Other people need treatment to lessen their body's immune system response. Sometimes sarcoidosis can last for years and may cause organ damage.

Symptoms

Symptoms of sarcoidosis vary, depending on which organs are affected and how badly they're affected. Sarcoidosis sometimes develops slowly over time and causes symptoms that last for years. Other times, symptoms appear suddenly and then disappear just as quickly. Many people with sarcoidosis have no symptoms, so the condition is found only when a chest X-ray is done for another reason.

General symptoms

Sarcoidosis can begin with these symptoms:

• Extreme tiredness.
• Slight fever.
• Swollen lymph nodes, such as in the chest, neck, armpits or groin.
• Weight loss.
• Pain and swelling in joints, such as the ankles.

Lung symptoms

Sarcoidosis most often affects the lungs and may cause lung problems, such as:

• Ongoing dry cough.
• Shortness of breath.
• A squeaking sound when breathing out, called wheezing.
• Chest pain.

Skin symptoms

Sarcoidosis may cause skin problems, which may include:

• A rash of small, itchy bumps, usually on the head, neck or legs. The rash may be painful.
• Open sores on the nose, lips, cheeks and ears, called skin lesions.
• Areas of skin that are darker or lighter in color.
• Growths under the skin, especially around scars or tattoos.

Eye symptoms

Sarcoidosis can affect the eyes without causing any symptoms, so it's important to have your eyes checked regularly. When eye symptoms do occur, they may include:

• Blurred vision.
• Eye pain.
• Watery eyes.
• Burning, itching or dry eyes.
• Severe redness.
• Sensitivity to light.

Heart symptoms

Symptoms related to cardiac sarcoidosis may include:

• Chest pain.
• Shortness of breath.
• Fainting.
• Heartbeats that aren't regular, called arrhythmias.
• Rapid or fluttering heartbeats, called palpitations.
• Swelling caused by extra fluid in the body.

Nervous system symptoms

Sarcoidosis can cause symptoms related to the brain and nerves, such as:

• Headaches.
• Dizziness.
• Changes in vision.
• Confusion.
• Weakness.
• Nerve pain, numbness or tingling.
• Seizures.

Other symptoms

Other symptoms are usually linked with the organs affected. Sarcoidosis can cause granulomas in any part of the body, such as the liver, spleen, muscles, bones and joints, kidneys, and lymph nodes.

When to see a doctor

See a doctor or other healthcare professional if you have symptoms that may be sarcoidosis.

Causes

The cause of sarcoidosis is not known. Experts think it results from a mix of genetic and environmental factors that cause the body's immune system to overreact to a substance it doesn't know.

Some people have gene changes that make their immune system more likely to overreact to triggers. Triggers could be bacteria, viruses, chemicals or dust. This causes immune cells to group into tiny collections of inflamed lumps called granulomas. As granulomas build up in an organ, the function of that organ can be affected.

Risk factors

While anyone can develop sarcoidosis, factors that may raise your risk include:

• Age and sex. Sarcoidosis can happen at any age, but often occurs between the ages of 20 and 60 years. Women are slightly more likely to develop the condition than are men.
• Race. Sarcoidosis occurs more often in people of African descent and those of Northern European descent. African Americans are more likely to have sarcoidosis in other organs along with the lungs.
• Job or hobbies. Working around chemicals and dust can raise your risk.
• Family history. If someone in your family has had sarcoidosis, you're more likely to get the condition.

Complications

Sometimes sarcoidosis causes long-term problems.

• Lungs. Pulmonary sarcoidosis that isn't treated can lead to scarring in the lungs that lasts forever. This scarring is called pulmonary fibrosis. Pulmonary fibrosis makes it hard to breathe and sometimes causes pulmonary hypertension.
• Eyes. Inflammation can affect almost any part of the eye. It may cause damage to the retina, which over time can affect vision. Sarcoidosis can cause cataracts and glaucoma.
• Kidneys. Sarcoidosis can affect how your body handles calcium. Sarcoidosis can result in too much calcium in the bloodstream, a condition called hypercalcemia. This can lead to kidney stones and affect how well the kidneys work. Rarely, long-term kidney disease can occur.
• Heart. Cardiac sarcoidosis results in granulomas in the heart. These can cause problems with heart rhythm, blood flow and heart function. Rarely, sarcoidosis results in heart problems that may cause death.
• Nervous system. Some people with sarcoidosis develop problems related to the central nervous system. This occurs when granulomas form in the nerves, brain and spinal cord. For example, granulomas in the facial nerves can cause paralyzed facial muscles.

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