Sarcoidosis

Sarcoidosis is an inflammatory disease that affects one or more organs but most commonly affects the lungs and skin. As a result of the inflammation, abnormal lumps or nodules known as granulomas form in one or more organs of the body. These granulomas may change the normal structure and possibly the function of the affected organ. The cause of sarcoidosis is unknown.

Sarcoidosis and tuberculosis are very similar and we have often encountered patients who have been misdiagnosed.

Diagnosis is suggested by the patient’s medical history, routine tests, a physical examination, and a chest X-ray. Many patients with sarcoidosis require no treatment.

RISK FACTORS

• Some exposures to dusty or moldy environments have increased risk of developing sarcoidosis.
• Women are more likely to develop the disease than men.
• People between 20 to 40 years of age are more likely to develop sarcoidosis than others.

COMMON SIGNS AND SYMPTOMS OF SARCOIDOSIS :

• Cough
• Shortness of breath
• Chest pain
• Wheezing or abnormal breathing
• Night sweats
• Feeling congested
• Fatigue

Sarcoidosis also can cause skin rashes or raised bumps on the skin, joint pain or stiffness, eye irritation, dryness of the eyes and sometimes blurry vision, fast heart rate or lightheadedness, kidney stones, increased levels of calcium in the bloodstream, abnormal liver function.

DIAGNOSIS :

Based on patient’s medical history, routine tests, a physical examination, physician 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 from an affected organ. From the lungs this is most easily and painlessly done by bronchoscopy.

TREATMENT :

Many patients with sarcoidosis may recover spontaneously without any drugs. Carefully selected patients are offered steroids which must be given under careful supervision.

There’s no cure for sarcoidosis, but in many cases it may recover spontaneously without any treatment. Patient may not require treatment if he/she has no symptoms or only mild symptoms of the condition. The severity and extent of your condition will determine whether and what type of treatment is needed.

• Medication: If your symptoms are severe or organ function is threatened, patient will be treated with medications. These may include, Corticosteroids. These powerful anti-inflammatory drugs are usually the first line treatment for sarcoidosis. Medications that suppress the immune system. Medications such as methotrexate (Trexall) and azathioprine (Azasan, Imuran) reduce inflammation by suppressing the immune system. Hydroxychloroquine, (Plaquenil) may be helpful for skin lesions and elevated blood-calcium levels. Tumor necrosis factor-alpha (TNF-alpha) inhibitors commonly used to treat the inflammation associated with rheumatoid arthritis.
• Monitoring: Symptoms will be monitored by the physician to determine the effectiveness of the treatments and check for complications. Monitoring may include regular tests based on patient’s condition. Routine tests may include chest X-rays, lab and urine tests, EKGs, and exams of the lungs, eyes, skin and any other organ involved.
• Surgery: If sarcoidosis has severely damaged lungs, heart or liver, organ transplant may be considered.

COMPLICATIONS :

Most people who are diagnosed with sarcoidosis don’t experience complications. However, sarcoidosis can become a chronic, or long-term, condition. Other potential complications may include lung infection, cataracts, glaucoma, kidney failure, abnormal heart beat, facial paralysis, infertility or difficulty conceiving.