Sarcoidosis – Symptoms, Causes, Diagnosis, and Treatments

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What is sarcoidosis?

Sarcoidosis is an inflammatory disease affecting multiple systems of unknown aetiology. They manifest as multiple tiny masses called granulomas, mainly in the lungs and intrathoracic lymph nodes.

Causes of sarcoidosis

The cause of the disease is unknown. However, both genetic and environmental factors have a major role. Sarcoidosis is neither infective nor malignant and is not autoimmune as well.  

Population affected

Sarcoidosis incidence peaks in persons between 25 and 35 years. A second peak occurs for women aged from 45 to 65 years. The male-to-female ratio is approximately 1:2.

Symptoms of Sarcoidosis

The manifestation of sarcoidosis varies with the extent and severity of organ involvement, as follows:

Fever and anorexia are seen in 40 to 50% of cases. Dyspnea on exertion, chest pain, cough and hemoptysis (rare) are seen in nearly 50% of cases. It is asymptomatic and incidentally detected on chest imaging in close to 5% of the cases.

Rare symptoms

  • It can affect the skin and cause a red rash or reddish-purple bumps usually located on the shin and ankles, which may be warm and tender to touch.  
  • Eye symptoms include blurring of vision, eye pain and severe redness.

How to diagnose sarcoidosis?

Imaging studies are pivotal for the diagnosis of sarcoidosis. A chest radiograph, routine CT scan of the chest or HRCT of the chest are needed to diagnose heart disease. Routine lab evaluation may reveal high serum calcium levels (hypercalcemia), increased calcium in the urine (hypercalciuria), elevated alkaline phosphatase levels and elevated angiotensin-converting enzyme (ECE) levels.  

Treatment for sarcoidosis

NSAIDs or Anti-inflammatory medication are required for joint pains and rheumatic complaints.

For patients with lung involvement, no treatment is required for asymptomatic individuals. Steroids are indicated for patients with significant respiratory symptoms.  

Steroid therapy is indicated by the involvement of critical organs such as the heart, liver, eyes, kidneys or central nervous system. Topical steroids are effective for ocular disease.  

To treat pulmonary disease, prednisone is generally given daily and tapered over a 6-month course. Inhaled corticosteroids in high doses may be an option, particularly in patients with the endobronchial disease.

Steroid-sparing agents such as Methotrexate, Hydroxychloroquine, Cyclophosphamide and Azathioprine may be used.  

Prognosis for sarcoidosis

Many patients do not require therapy for sarcoidosis, and their conditions improve spontaneously.   

Markers for a poor prognosis encompass advanced chest radiography stage, evidence of pulmonary hypertension and extrapulmonary disease (predominantly cardiac and neurologic).

Deaths usually tend to occur due to end-stage lung disease. Overall mortality is less than 5% in untreated patients.  

Conclusion

Sarcoidosis is a rare yet common disease which can be tackled easily if the proper protocol and timely intervention and management are followed. Mortality comes only if the disease is left undiagnosed and untreated.  

FAQs

Is sarcoidosis heriditary?

It has a genetic element and can rarely run in families due to the same reason.

Is there any specific diet for patients with sarcoidosis?

Eating a balanced diet is the key. No specific food item or diet is recommended in the management of sarcoidosis. Eating a diet rich in anti-inflammatory food may have a positive effect on controlling the disease.
 
Anti-inflammatory foods are usually unprocessed. They contain no added sugar, additives or chemicals and are consumed in their whole food state, i.e. with skins-on vegetables, whole grains, etc. They possess lots of antioxidants, minerals and healthy oils, which are essential for a healthy immune system.

Is treatment for sarcoidosis lifelong?

Yes, it can be lifelong to some patients. Usually, sarcoidosis symptoms disappear within 1 or 2 years, and rarely the complications or sequelae of sarcoidosis will remain.

What progress is being made in sarcoidosis research?

There is some positive progress in sarcoidosis research worldwide. The finding that mTOR, a signalling pathway, could influence the growth of granulomas led to many successive studies into understanding better how this new information could lead to a viable treatment for sarcoidosis.


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The Information including but not limited to text, graphics, images and other material contained on this blog are intended for education and awareness only. No material on this blog is intended to be a substitute for professional medical help including diagnosis or treatment. It is always advisable to consult medical professional before relying on the content. Neither the Author nor Star Health and Allied Insurance Co. Ltd accepts any responsibility for any potential risk to any visitor/reader.

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