Sarcoidosis is an inflammatory disease that affects one or more organs but most commonly affects the lungs and lymph glands. As a result of the inflammation, abnormal lumps or nodules (called 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(s).
Sarcoidosis usually starts in the lungs or lymph nodes in the chest. It is thought that inflammation of the alveoli (tiny sac like air spaces in lungs where carbon dioxide and oxygen are exchanged) is the start of the disease process in the lungs. This may either clear up on its own or lead to granuloma formation and fibrosis (scarring). Over 90% patients have some type of lung problem. Once considered a rare disease, sarcoidosis is now the most common of the fibrotic lung disorders.
Many people with sarcoidosis have no symptoms at all. But in others, the condition can cause long-term organ damage. For example, some people have fiber-like scar tissue in the lungs, which can cause breathing problems. Sarcoidosis may develop over time and cause symptoms that last for years, or it may show up and go away quickly.
People who have a variation of sarcoidosis, called Lofgren’s syndrome, may have symptoms that include swollen lymph nodes, fever, painful, reddened nodules, and joint pain. Lofgren’s syndrome generally tends to clear up on its own within 1 to 2 years.
Who is at Risk?
Sarcoidosis affects people of all ages and races. However, it’s more common among African Americans and Northern Europeans. In the United States, the disease affects African Americans somewhat more often and more severely than Whites.
Sarcoidosis is somewhat more common in women than in men. The disease usually develops between the ages of 20 and 50. People who have a family history of sarcoidosis also are at higher risk for the disease.
Causes
No one knows exactly what causes sarcoidosis, but it is probably due to a combination of factors. Some research suggests that bacteria, viruses or chemicals might trigger the disease. Although such triggers might not bother most people, it is possible that in someone with the right genetic predisposition they provoke the immune system to develop the inflammation associated with sarcoidosis.
The fact that a person is more likely to develop the disease if someone in his or her close family has the disease strongly suggests that genetics plays a role. Researchers have not discovered the genes for sarcoidosis yet, but it seems likely that more than one gene is involved.
It’s still uncertain which foreign substance “triggers” the body’s abnormal response. Some researchers suggest that fungi, viruses, or bacteria are likely triggers. In fact, cases of sarcoidosis have occurred in groups of people who had close contact with each other, as well as in recipients of heart, lung and bone marrow transplants. But, so far, no data have been able to convincingly and consistently establish this “infectious” connection as the cause of the disease. However, some types of bacteria have recently emerged as possible candidates and continue to be closely studied.
Symptoms
Many people with sarcoidosis do not have any symptoms. Others have only vague symptoms that can be seen in many other illnesses, such as weight loss, fever, loss of appetite, depression, night sweats, and sleep problems. Symptoms that may come from problems with a specific organ include –
- Lungs – Shortness of breath, wheezing or dry cough that may disappear over time.
- Lymph nodes – Enlarged and sometimes tender lymph nodes, most often in the neck and chest, but sometimes under the chin, arm pits or groin.
- Eyes – Burning, itching, tearing, redness, sensitivity to light, dryness, seeing black spots, blurred vision, reduced color vision, and, in rare cases, blindness.
- Skin – Bumps, ulcers, or rarely, flat areas of discolored skin that appear mostly near the nose or eyes or on the back, arms, legs and scalp. Painful and tender bumps can also appear on the ankles and shins.
- Bones and Joints – Bone lumps (nodules), causing pain in the hands and feet and sometimes pain and swelling in the ankles or other joints.
- Spleen and Liver – Fever, fatigue or itching. There can be pain in the upper right part of the abdomen, under the rib.
- Heart – Shortness of breath, swelling in the legs, wheezing, coughing, and chest pain. One may have a feeling of an irregular or fast heart beat at times, or even pass out without warning.
- Salivary Glands – Swelling (which may make the cheeks look puffy) and an overly dry mouth and throat.
- The Nervous System – Headaches, vision problems, weakness or numbness of an arm or leg, drooping of one side of the face, loss of movement in the arms or legs, weakness, pain or a “pins and needles” feeling.
Treatment
Medications
Corticosteroids, such as prednisone are considered the first-line treatment for lowering inflammation from sarcoidosis. Corticosteroid pills can have some serious side effects if taken in high doses for long periods. Side effects may include –
- High blood pressure
- Diabetes
- Stomach ulcers
- Tuberculosis
- Osteoporosis
Other medications sometimes used for sarcoidosis include those that suppress the immune system, such as –
- Methotrexate
- Azathioprine (Imuran)
- Infliximab (Remicade)
Other medications that may be used include –
- Antimalarial drugs: such as hydroxychloroquine, used when the skin is affected. It may be toxic to the eyes.
- Thalidomide: being studied for sarcoidosis, used to improve lung function and treat skin problems.
- Topical therapies: including steroid creams, eye drops, nasal corticosteroids, and steroid inhalers.
Alternative Treatment
A daily multivitamin – Containing the antioxidant vitamins A, C, E, the B-complex vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.
Omega-3 fatty acids – Such as fish oil, 1 to 2 capsules or 1 to 3 tbsp of oil, 1 to 3 times daily. Fish oil seems to help reduce inflammation throughout the body. Cold-water fish, such as salmon or halibut, are good choices to eat.
Bromelain – A mixture of enzymes derived from pineapple, 500 mg per day. Bromelain may also help reduce inflammation in the body.
Probiotic supplement (containing Lactobacillus acidophilus) – These “friendly” bacteria help maintain gastrointestinal health.
Turmeric & Cat’s claw – This may help reduce inflammation.
Reference –
http://www.medicinenet.com/sarcoidosis/article.htm
https://www.blf.org.uk/Page/What-is-sarcoidosis
https://www.thoracic.org/patients/patient-resources/resources/what-is-sarcoidosis.pdf
http://www.wasog.org/pdfs/sharma.pdf
http://www.nejm.org/doi/pdf/10.1056/NEJMra071714
http://www.sarcoidosisonlinesites.com/cardiac_sarcoidosis.pdf
http://www.mayoclinic.org/diseases-conditions/sarcoidosis/basics/causes/con-20022569