Sarcoidosis is an inflammatory disease in which granulomas, or clumps of inflammatory cells, form in various organs. This causes organ inflammation.
Sarcoidosis may be triggered by your body’s immune system responding to foreign substances, such as viruses, bacteria, or chemicals.
The areas of the body commonly affected by sarcoidosis include:
- lymph nodes
- lungs
- eyes
- skin
- liver
- heart
- spleen
- brain
Note
Sex and gender exist on spectrums. This article will use the terms “men,” “women,” or both to refer to sex assigned at birth.
Some people with sarcoidosis don’t have any symptoms. However, general symptoms may include:
Symptoms vary depending on the part of your body that’s affected by the disease. Sarcoidosis can occur in any organ, but it most commonly affects the lungs. Lung symptoms can include:
- a dry cough
- shortness of breath
- wheezing
- chest pain around your breastbone
Skin symptoms can include:
- skin rashes
- skin sores
- hair loss
- raised scars
Nervous system symptoms can include:
Eye symptoms can include:
- dry eyes
- itchy eyes
- eye pain
- vision loss
- a burning sensation in your eyes
- discharge from your eyes
The exact cause of sarcoidosis is unknown. However, sex, race, and genetics can increase the risk of developing the condition:
- Sarcoidosis is more common in women than in men.
- People of African American descent are three times more likely to develop the condition than white people. They’re also more likely to have severe disease.
- People with a family history of sarcoidosis have a significantly higher risk of getting the disease.
Sarcoidosis rarely occurs in children. Symptoms usually appear in people between the ages of 20 and 40.
It can be difficult to diagnose sarcoidosis. Symptoms can be similar to those of other diseases, such as arthritis or cancer. Your doctor will run a variety of tests to make a diagnosis.
Your doctor will first perform a physical examination to:
- check for skin bumps or a rash
- look for swollen lymph nodes
- listen to your heart and lungs
- check for an enlarged liver or spleen
Based on the findings, your doctor may order additional diagnostic tests:
- A chest X-ray can be used to check for granulomas and swollen lymph nodes.
- A chest CT scan is an imaging test that takes cross-sectional pictures of your chest.
- A lung function test can help determine whether your lung capacity has become affected.
- A biopsy involves taking a sample of tissue that can be checked for granulomas.
Your doctor may also order blood tests to check your kidney and liver function.
If you need help finding a primary care doctor or dermatologist, you can browse doctors in your area through the Healthline FindCare tool.
Sarcoidosis can affect any part of the body, but it commonly impacts the lungs. Pulmonary sarcoidosis, or sarcoidosis of the lungs, can be categorized into four stages.
Staging helps doctors understand how advanced the condition is. It can also help them understand which treatments might be right for you.
A stage is assigned after a chest X-ray. This imaging test reveals several important factors about how the condition is affecting your lungs.
- Stage 1. Lymph nodes near the heart and lungs are enlarged, but there is no fluid or substances in the lungs. Granulomas may be found if a lung tissue biopsy is taken.
- Stage 2. Enlarged lymph nodes near the heart and lungs are present, and infiltrates (blood, pus, or proteins) are found in the lungs as well.
- Stage 3. Infiltrates are present in the lungs, but the lymph nodes are not enlarged or swollen.
- Stage 4. Lungs show obvious signs of pulmonary fibrosis. Damaged or scarred lung tissue prevents the lungs from working properly and filling up fully with air.
There’s no cure for sarcoidosis. However, some people do not need treatment for sarcoidosis. Symptoms often improve without treatment. This is called “spontaneous remission.”
Treatment may be needed if the disease affects your:
- eyes
- lungs
- heart
- nervous system
If you do need treatment, your doctor will assess your symptoms and how advanced the condition is. They may prescribe medications to help suppress the immune system and reduce inflammation. This can ease the symptoms of sarcoidosis.
Medications used to treat sarcoidosis include:
- Corticosteroids. Prednisone is the most commonly prescribed treatment for sarcoidosis. However, the side effects of this medication can be severe, so it may only be prescribed for a short period of time.
- Disease modifying antirheumatic drugs (DMARDs). DMARDs are medications that suppress the immune system. They may slow the progression of sarcoidosis and reduce symptoms. Examples include methotrexate (Trexall), azathioprine (Azasan), and leflunomide (Arava).
- Antimalarial agents. Medications like hydroxychloroquine (Plaquenil) may be helpful for sarcoidosis symptoms that affect the skin and joints.
- Biologic agents. These medications are used to stop an overactive immune system. They have significant side effects, so they’re typically reserved for people whose bodies do not tolerate other medications. Examples include rituximab (Rituxan), infliximab (Remicade), and golimumab (Simponi).
The length of any treatment will vary. Some people take medication for 1 to 2 years. Other people may need to take medication for much longer.
Most people who receive a diagnosis of sarcoidosis don’t experience complications. However, sarcoidosis can become a chronic, or long-term, condition. Other potential complications may include:
- lung infection
- retinal damage from chronic inflammation
- cataracts, which are characterized by clouding of the lens in your eye
- glaucoma, which is a group of eye diseases that can cause blindness
- kidney failure
- atypical heartbeat
- facial paralysis
- infertility in men or difficulty conceiving due to sarcoidosis affecting the testes
In rare cases, sarcoidosis causes severe heart and lung damage. If this occurs, you may need immunosuppressive medications.
It’s important to contact your doctor if you have:
- breathing difficulties
- heart palpitations, which occur when your heart is beating too fast or too slow
- changes in your vision or loss of vision
- eye pain
- sensitivity to light
- facial numbness
These can be signs of dangerous complications.
Your doctor may recommend that you see an optometrist or ophthalmologist because this disease can affect your eyes without causing immediate symptoms.
The outlook is generally good for people with sarcoidosis. Many people live relatively healthy, active lives. Symptoms often improve with or without treatment in about 2 years.
In some cases, however, sarcoidosis can become a long-term condition. If you need help coping, you can talk with a psychotherapist or join a sarcoidosis support group.
Is sarcoidosis an autoimmune disease?
Some scientists believe sarcoidosis is an autoimmune disease. That is, they think it’s the result of the body mistakenly attacking itself instead of foreign bodies like viruses or bacteria.
It often overlaps with other known autoimmune diseases like rheumatoid arthritis and autoimmune thyroid disease.
However, it also appears factors like genetics and environmental exposures may play a role. So
What is the life expectancy for someone with sarcoidosis?
People with asymptomatic sarcoidosis do not usually require treatment. In fact, many will remain stable for years without advancing symptoms.
Those who do develop advanced symptoms or complications often have a favorable outlook. Overall, the mortality rate in untreated people is
But the long-term outlook for untreated people can be difficult. Respiratory failure from severe scarring is possible, and it can lead to death.
How does a person get sarcoidosis?
Researchers and doctors do not understand precisely what causes sarcoidosis. It’s also not entirely clear why some people reach remission and never relapse, while others progress into advanced stages.
There are some factors, like genes and environmental exposures, that may impact who develops sarcoidosis and who doesn’t. But new areas of investigation are looking at why this condition develops and what, if anything, can be done to prevent it.