Sarcoidosis: Causes, Symptoms, Diagnosis & Treatment

Key Facts About Sarcoidosis You Should Know

Sarcoidosis is a complex inflammatory disease, defined by the formation of granulomas in one or more organs, most commonly the lungs and lymph nodes. Impacting anywhere from 2 to 160 individuals per 100,000 globally, sarcoidosis is a multi-faceted and frequently misunderstood disease. It is an inflammatory illness characterised by the presence of abnormal collections of immune cells (granulomas), but it is neither cancerous nor infectious.

Sarcoidosis may affect nearly any area of the body, but it most frequently affects the lungs and lymph nodes. In severe cases, sarcoidosis can be life-threatening if it progresses to heart or severe lung disease.

Keep reading to learn more about this illness, including its symptoms, causes, diagnosis, treatment, and other crucial aspects.

What is Sarcoidosis?

Sarcoidosis is an ongoing inflammatory disease in which the immune system reacts too strongly, creating small collections of immune cells known as granulomas. They typically occur in the lungs and lymph nodes, but can also be found in the eyes, skin, heart, and other organs.

Even though harmless, granulomas can become so irritating that they can damage organs if they persist. No one is certain of the cause, and a combination of genetic and environmental factors—such as exposure to dust, bacteria, or viruses—is likely responsible. Sarcoidosis might just go away or may need treatment when severe.

What are the Symptoms of Sarcoidosis?

Discussed below are the common symptoms of sarcoidosis:

• Fatigue, low-grade fever, night sweats, unexpected weight loss, swollen lymph nodes (neck, chest, armpits, andgroin), muscle weakness, joint pain or swelling, and kidney stones.
• Recurring dry cough, shortness of breath, chest pain, and wheezing.
• Painful or itchy rashes (usually on skin, face, or neck), papules, discolouredor scaly patches, bumps around scars or tattoos, facial open sores, and nail deformities or hair loss.
• Blurred vision, pain in the eyes, dry or irritatedeyes, watery eyes, redness, burning, and sensitivity to light.
• Pain in the chest, abnormal or palpably irregular heartbeat, passing out, swelling in the legs from fluid retention, and manifestations of heart failure.
• Headaches, dizziness, seizures, confusion, changes in vision, weakness, numbness, pain in nerves, loss of hearing, taste, or smell, and changes in mood or mental status.
• Sarcoidosis can affect the liver, kidneys, bones, muscles, and spleen, potentially leadingto pain, swelling, or organ malfunction.
• Acute fever, joint inflammation/swelling (usually migrating), enlargement of chest lymph nodes, and tender red nodules (erythema nodosum) on the legs—most prevalent in spring and in young adult females.

How Sarcoidosis Affects Your Body?

The exact cause of sarcoidosis is unknown. However, it is associated with an increased and dysregulated immune system activity. This leads to the formation of clusters of immune cells, known as granulomas, which can form within and infiltrate your organs and lymph nodes. Sarcoidosis most commonly impacts the lungs and lymph nodes (especially within the chest). Other commonly affected organs include the skin, eyes, liver, and spleen. The symptoms of sarcoidosis differ depending on which organ is affected by the disease as well as its severity level.

Other way of explain the severity of disease is by how many organs are involved. Like in the lungs, sarcoidosis in organs apart from the lungs can range from mild to severe. Other than the lungs the most common organs which are involved are the skin and eyes. Moreover, some organs such as liver and spleen can be indulged in sarcoidosis but do not need treatment. However, heart and brain, usually need treatment in case these organs are involved.

What are the Stages of Sarcoidosis?

The classification of sarcoidosis stages is done using the Siltzbach system, which relies on chest X-ray results and does not necessarily indicate the severity of the disease. The stages are outlined as follows:

• Stage 0: There are no indications of sarcoidosis, andboth the lungs and lymph nodes appear normal on the X-ray.
• Stage 1:Granulomas are found solely in the lymph nodes, usually located in the chest region.
• Stage 2:Granulomas are observed in both the lungs and lymph nodes.
• Stage 3:Granulomas are detected in the lungs but not in the lymph nodes.
• Stage 4:There is visible permanent lung scarring (pulmonary fibrosis)—this stage is the only one that is irreversible.

How to Diagnose Sarcoidosis?

Diagnosis of sarcoidosis usually depends on a combination of imaging, biopsy, clinical evaluation, and tests to exclude other illnesses. Here is a detailed overview:

• Medical History and Physical Exam: The diagnosis starts with a complete history of your symptoms and medical history, followed by a physical examination to evaluate for swelling in the lymph nodes, skin lesions, or shortness of breath.
• Imaging Tests: Chest X-ray, CT scan, MRI, or PET scan are included, which can be used to assess other organs and check for inflammation. It also incorporates nuclear imaging (such as gallium or PET scans) that can emphasise active inflammation with the use of a minimal amount of radioactive material.
• Biopsy: This procedure examines tissue samples to verify the existence of granulomas. The most common biopsy areas are the skin, lungs, lymph nodes, and eyes.
• Lab Tests: This comprises blood and urine tests to monitor kidney, liver, and other organ functions. It may also measure calcium levels or angiotensin-converting enzyme (ACE) levels, which are raised in sarcoidosis.
• Pulmonary Function Tests: To assess lung capacity and function in order to test breathing capability and identify impairment.
• Eye Exams: Slit-lamp inspection is utilised to examine the eyes for inflammation, even when symptoms are not apparent.
• Heart and Nerve Tests: Electrocardiogram (EKG/ECG) identifies abnormal heart rhythms or other electrical activity problems. Furthermore, neurological tests determine possible brain and nerve involvement.

How to Treat Sarcoidosis?

Currently, there is no cure for sarcoidosis, but treatment is available for those with severe symptoms or organ involvement. Some people will experience spontaneous remission and not require treatment.

For the majority of cases, when treatment is necessary, it typically involves:

• Corticosteroids such as prednisone canhelp reduce inflammation
• Medications to suppress the immune system (DMARDs, antimalarials, or anti-TNF-alpha medications such as infliximab)
• NSAIDs for sporadic symptom relief
• Utilisation of corticotropin injections(in rare cases)

What is a Sarcoid-like Disease?

Also known as sarcoid-like reaction (SLR), it is a condition which is characterised by the non-caseating epithelioid cell granuloma lesions of sarcoidosis. However, it does not exhibit the accompanying systemic symptoms.

Histologically, SLR is indistinguishable from systemic sarcoidosis and is observed in individuals with various malignancies.

Is Sarcoid a Serious Ailment?

Sarcoidosis is serious, but its severity tends to vary significantly among individuals. In some people, it heals by itself or can be treated well with minimal long-term effects.

However, in several individuals, the disease may develop into a chronic and progressive condition, resulting in permanent organ damage—especially if major organs like the lungs, heart, or brain are involved. Prompt diagnosis and care are the keys to managing its complications and achieving improved results.

Furthermore, having a comprehensive health insurance policy helps, as it enables access to quality treatment without having to worry about the financial implications.

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