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What Exactly is Sarcoidosis: Symptoms and Treatment

A slide titled "Sarcoidosis" displaying a semi-transparent human torso with highlighted granulomas.

Sarcoidosis is a disease that causes some parts of your body to swell up because too many immune cells come together to form tiny lumps. The inflammation can happen anywhere in your body, but it’s most common in the lungs. 

When it affects your lungs, you may feel chest pain, have a hard time breathing, or cough a lot. Sometimes, you may not feel sick at all, but for others, it can cause fatigue, fevers, sore joints, and weight loss. 

It can also affect the skin, causing red and painful spots, usually on the legs. It can even make your eyes red, dry, or blurry. If you experience any of these symptoms, it’s important to see a doctor because sarcoidosis can affect how your body functions.

Recognizing Sarcoidosis Symptoms

When it comes to sarcoidosis, understanding the symptoms is key. Below are the listed symptoms categorically for easy understanding. 

Pulmonary Sarcoidosis:

  • Persistent dry cough
  • Difficulty breathing or shortness of breath
  • Chest pain, often a pressure behind the breast bone

General Discomfort:

  • Persistent fatigue, feeling overly tired
  • Fevers without any apparent cause
  • Joint pains, which may feel like aches or sharp pains
  • Unintended weight loss

Skin Concerns:

  • Unusual hair loss
  • Erythema nodosum: painful, raised, red lumps on the lower legs
  • Rashes that can appear on different parts of the body
  • Scars on the skin becoming raised or inflamed

Neurological Signs:

  • Frequent headaches
  • Seizures, in some cases
  • Facial weakness, typically on one side

Ocular Challenges:

  • Burning or itching sensation in the eyes
  • Dry eyes that may feel gritty
  • Eye pain that can range from mild to severe
  • Possible vision loss if not treated early

Other Symptoms:

  • Dry mouth that feels uncomfortable
  • Unexpected nosebleeds
  • Swelling in the legs or upper abdomen, possibly indicating heart or liver involvement

These symptoms can vary greatly from person to person, and not everyone with this illness will experience all of them. It’s important to pay attention to these signs and consult a healthcare provider for proper diagnosis and management.

Early Diagnosis can be a Critical Step

Examination and Tests:

  • Doctors start by checking for sarcoidosis through a physical exam and a detailed discussion about your symptoms.
  • They’ll look for signs like skin bumps or rashes and listen to your lungs.
  • Reviewing your medical history is also essential to rule out other conditions.

Imaging Insights:

  • A chest X-ray is often the first imaging test done, looking for signs of lung involvement or enlarged lymph nodes.
  • A CT scan of the chest gives a more detailed picture, helping doctors see the lungs and lymph nodes more clearly.
  • PET scans can be used, too. They help show where the inflammation is active in your body.

Biopsy and Lab Work:

  • To confirm the diagnosis, doctors may need to take a small sample of tissue, usually from the lungs. This procedure is called a bronchoscopy.
  • Blood tests are important, too. They check your calcium levels and the enzyme ACE, which can be higher in people with sarcoidosis.
  • These tests together help doctors figure out if you have sarcoidosis and how it might be affecting you.

Understanding Sarcoidosis Treatment Strategies

Who needs the Treatment:

  • Not everyone with sarcoidosis needs treatment. If your symptoms are mild, doctors might watch and wait.
  • Many times, the illness gets better on its own, especially if it’s only affecting the lungs a little bit.

Corticosteroids:

  • For more serious symptoms, doctors often prescribe corticosteroids.
  • These medications can reduce inflammation in organs like the lungs, eyes, or heart.
  • You might have to take them for 1 to 2 years, sometimes even longer.

Immunosuppressants:

  • Some people may need other medications that calm down the immune system.
  • These are given when steroids aren’t enough or if someone has severe symptoms.

Severe Cases:

  • In rare, serious cases, when the heart or lungs are badly damaged, a transplant might be the only option.
  • If sarcoidosis affects the heart rhythm, an implantable cardioverter-defibrillator (ICD) might be needed to keep the heartbeat regular.

In these two sections, your doctor’s detective work and the careful management plan they craft can make all the difference.

What are the Potential Complications

While many individuals do not experience severe complications, it’s important to be aware of the potential risks. One possible complication is aspergillosis, a type of lung infection caused by a fungus. 

This can occur when sarcoidosis has caused extensive lung damage. Glaucoma, a condition that can lead to blindness, may also develop, particularly when sarcoidosis involves the eyes.

Another concern is the development of kidney stones, which can occur due to increased calcium levels in the blood or urine—a known side effect of sarcoidosis. Additionally, prolonged use of corticosteroids, often prescribed for sarcoidosis, can lead to osteoporosis, a weakening of the bones.

Lastly, sarcoidosis can lead to pulmonary hypertension, a serious condition where there is too much pressure in the blood vessels going from the heart to the lungs. This can happen when sarcoidosis damages the lung’s delicate tissues.

When to Seek Medical Advice

It is critical for individuals with sarcoidosis to be in regular contact with their healthcare provider. However, certain symptoms should prompt immediate medical advice. Difficulty breathing or a sensation of not getting enough air can indicate worsening lung involvement or pulmonary hypertension and require urgent attention.

An irregular heartbeat could be a sign that sarcoidosis is affecting the heart and necessitate immediate intervention. Changes in vision, such as blurriness, seeing spots, or sudden vision loss, are also signs that the eyes could be severely impacted and require prompt medical care.

Other symptoms that warrant a call to the doctor include persistent chest pains, severe abdominal swelling, uncontrolled coughing, or coughing up blood. Essentially, any new, worsening, or concerning symptoms should be discussed with a healthcare professional to ensure timely and appropriate care.

Managing Life with Sarcoidosis

Recognizing the symptoms early on—whether they’re respiratory issues like coughing and shortness of breath, general body discomfort like fever and joint pain, or something more specific like skin rashes or vision problems—is the first step toward getting the right care.

Treatment for sarcoidosis can range from a watchful waiting approach to medications like corticosteroids and immunosuppressants. Some may require long-term management, while others might find their symptoms resolved without intensive treatment. The key is to work closely with healthcare providers to create a personalized management plan and keep up with regular check-ups to ensure the best possible outcomes.

With knowledge comes empowerment. By understanding sarcoidosis, its symptoms, and the available treatments, those affected can take charge of their health and make informed decisions about their care. 

Using cough syrups, nebulizers and tablets blindly can delay the diagnosis leading to the progression of the disease. Consult a good pulmonologist to get it evaluated.

FAQs

1. What are the common sarcoidosis symptoms?

Sarcoidosis symptoms can vary widely depending on which part of the body is affected. In cases of pulmonary sarcoidosis, common symptoms include persistent cough, chest pain, and shortness of breath. Other general symptoms may include fatigue, fever, and skin lesions.

2. How is sarcoidosis diagnosed?

Sarcoidosis diagnosis typically involves a combination of clinical evaluation, imaging, and laboratory tests. Imaging tests, especially a chest X-ray, are crucial for identifying sarcoidosis of the lung. A biopsy may be required to confirm the presence of granulomas, which are indicative of disease.

3. What are the treatments available?

Sarcoidosis treatment depends on the severity and symptoms of the disease. Common sarcoidosis medication includes corticosteroids to reduce inflammation. For more specific treatment, especially in cases of pulmonary sarcoidosis, other forms of sarcoidosis medication, such as immunosuppressants, may be used.

4. What exactly is pulmonary sarcoidosis?

Pulmonary sarcoidosis is a form of sarcoidosis disease that specifically affects the lungs. It is one of the most common manifestations, where granulomas form in the lung tissues. This condition can lead to persistent cough, chest discomfort, and other respiratory issues.

5. Are there any specific tests for sarcoidosis of the lung?

Doctors typically recommend imaging tests like a chest X-ray or CT scan along with lung function tests to diagnose sarcoidosis of the lung. These tests help assess the extent of granuloma formation and lung involvement in the disease.

6. How do doctors confirm the presence of sarcoidosis granulomas?

The presence of granulomas is usually confirmed through a biopsy. This involves taking a small tissue sample from the affected area, which is then examined under a microscope. Finding granulomas is key for a definitive sarcoidosis diagnosis.

7. What should patients know about sarcoidosis medication?

Patients should be aware that medication typically aims to control inflammation and manage symptoms. Corticosteroids are the most commonly prescribed medication, but depending on the patient’s condition and response to treatment, other drugs may also be necessary.

8. Can sarcoidosis be cured?

Currently, there is no cure for this disease, but many patients find their symptoms improve with treatment. The effectiveness of this treatment varies, with some patients experiencing complete remission and others requiring ongoing management.

  • Dr.Vivek Vardhan Veerapaneni

    Dr. Vivek Vardhan Veerapaneni, an esteemed pulmonologist who excels in Clinical, Interventional Pulmonology with special training in Allergy and Sleep medicine. His clinical acumen and ability in treating respiratory conditions spreads over 10 years. His Qualifications are MBBS, MD in Pulmonary Medicine, DAA(CMC, Vellore), EDARM (Switzerland) and DPSM. He has special interest in Allergy, Asthma, COPD, and ILD, alongside Interventional Pulmonology and Sleep disorders management. Renowned for his compassionate care, Dr. Veerapaneni is dedicated to enhancing the quality of life for his patients, embodying a vision where everyone enjoys the benefits of healthy breathing.

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