What is Sarcoidosis?

Most sarcoidosis patients have no symptoms at all. In pulmonary sarcoidosis, patients may have a dry cough (without sputum), shortness of breath, or mild chest pain. There also can be fatigue, weakness, and weight loss. These symptoms are common in many other lung diseases, so diagnosis may be difficult. In those cases where symptoms do appear outside the lung, they can include a scaly rash, red bumps on the legs, fever, soreness of the eyes, and pain and swelling of the ankles.

About 50 percent of sarcoidosis patients improve spontaneously. The disease is fatal in less than 5 percent of patients. In between the two extremes, patients have mild to severe sarcoidosis, with various degrees of impairment, or none at all.

Sarcoidosis is found throughout the world within almost all races and ages and in both sexes. However, it is most common among American blacks and northern European whites. 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. In the United States, a higher percentage of blacks than whites have sarcoidosis, and the disease is usually more serious in blacks. The prevalence of sarcoidosis is 10 to 17 times greater in blacks than whites in the U.S.

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 the instance: pine pollen, spray deodorants, or broken fluorescent light bulbs. None has stood the test of time and analysis. Some physicians believe sarcoidosis results from inhalation of an infectious or allergic substance from the environment. Others believe that the disease is a basic problem in alteration of the cellular immune system.

Ninety percent of the cases of sarcoidosis are found in the lungs. Other sites are: Skin, Liver, Lymph glands, Spleen, Eyes, Nervous system, Musculoskeletal system (the muscles and bones in the body), Heart, Brain, and Kidneys.

In most cases of sarcoidosis there are no symptoms, the disease "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 fiber-like scar tissue in the lung). This actually distorts the structure 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.

In a majority of patients, the disease spontaneously disappears, and no treatment is necessary. Drugs called cortiocosteroids are the most important treatment used in fighting sarcoidosis. Some physicians prescribe steroids when there are no symptoms but just abnormalities seen on the chest x-ray and 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.

The sarcoidosis patient should follow his or her doctor's directions. This frequently can be just continuation of a normal lifestyle. When drugs are prescribed, they should be taken faithfully, just as the physician directs. It is particularly important that sarcoidosis patients do not smoke.

Sarcoidosis, which has an unknown cause, can be serious in some people, even causing death. Generally, though, the disease is not serious, coming and going and then disappearing. In many patients, sarcoidosis does not have symptoms. When there are granulomas, corticosteroids are most often used to combat the inflammation.