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Sarcoidosis

Also Known As: Sarcoid, Granulomatous disease, Multisystem granulomatous disorder
System: Immune System, Respiratory System, Integumentary System, Heart and Vascular System, Eyes, and Nervous System
Autoantibodies:
  • No specific autoantibody is used to diagnose sarcoidosis

  • Some patients may have positive ANA or rheumatoid factor

  • Immunologic dysregulation is evident, but it’s not classically autoimmune

Primary Organ or Body Part Affected:
  • Lungs and lymph nodes

  • Can also affect skin, eyes, heart, liver, nervous system, and kidneys

Acceptance as Autoimmune: Confirmed
Sarcoidosis

What is Sarcoidosis?

Sarcoidosis is a chronic inflammatory disease where the body forms small clusters of immune cells called granulomas in various organs. These granulomas can interfere with organ function and cause a wide range of symptoms, depending on where they form.

The lungs and lymph nodes are most commonly affected, but sarcoidosis can involve the skin, eyes, heart, liver, brain, and other organs. It’s considered an immune-mediated disease and is sometimes classified as autoimmune, although the exact mechanism is not fully understood.

What are the signs and symptoms of Sarcoidosis?

General symptoms:

  • Fatigue

  • Fever

  • Weight loss

  • Night sweats

Lung symptoms (most common):

  • Persistent dry cough

  • Shortness of breath

  • Chest pain

  • Wheezing

Skin symptoms:

  • Reddish bumps or patches (especially on the shins, called erythema nodosum)

  • Lupus pernio – purple discoloration on the nose, cheeks, ears

Eye symptoms:

  • Blurred vision

  • Eye pain or redness

  • Light sensitivity

Other possible symptoms:

  • Swollen lymph nodes

  • Joint pain

  • Irregular heartbeat or heart failure (if heart is affected)

  • Neurological symptoms like facial paralysis or seizures (rare)

What are the causes of Sarcoidosis?

The exact cause is unknown, but it’s believed to result from an overactive immune response triggered by:

  • Environmental exposures (e.g., dust, mold, chemicals)

  • Infections (e.g., mycobacteria or viruses)

  • Genetic predisposition (runs in some families)

It is not contagious.

Diagnosis

There’s no single test to diagnose sarcoidosis. It is often a diagnosis of exclusion, requiring:

  • Chest X-ray or CT scan (shows granulomas or lymph node enlargement)

  • Lung function tests

  • Biopsy of affected tissue showing granulomas

  • Blood tests (may show elevated ACE levels, calcium, or inflammation)

  • Eye and heart exams (to detect organ involvement)

Treatment

Many people with sarcoidosis do not need treatment if symptoms are mild and organs are not impaired.

If treatment is needed:

  • Corticosteroids (e.g., prednisone) – first-line treatment

  • Immunosuppressive drugs – methotrexate, azathioprine, hydroxychloroquine

  • Biologics (e.g., infliximab) in resistant cases

  • Organ-specific care (e.g., pacemaker for cardiac involvement)

Prognosis

  • About 50–70% recover without lasting problems

  • Some people have chronic or relapsing symptoms

  • Can lead to permanent lung damage, blindness, heart failure, or nerve injury if severe or untreated

  • Better prognosis in people with acute, limited disease (e.g., only lungs or skin involved)

Prevalence

  • Affects about 10 to 40 per 100,000 people in the U.S.

  • More common in African Americans and Northern Europeans

  • Usually appears between ages 20 and 40

  • Slightly more common in women

Citations

  1. National Heart, Lung, and Blood Institute (NHLBI). (2023). Sarcoidosis.
    https://www.nhlbi.nih.gov/health/sarcoidosis

  2. Mayo Clinic. (2023). Sarcoidosis.
    https://www.mayoclinic.org/diseases-conditions/sarcoidosis

  3. Baughman, R. P., et al. (2001). Sarcoidosis. The Lancet, 361(9363), 1111–1118.
    https://doi.org/10.1016/S0140-6736(03)12888-7

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