Sarcoidosis

WHAT YOU SHOULD KNOW

This mysterious disease is marked by a host of tiny inflammations that erupt in one or more parts of the body. The inflamed nodules are most commonly found in the lungs, but can also appear in the lymph nodes, liver, skin, and eyes. Occasionally the spleen, heart, nervous system, bones, joints, and skeletal muscles also come under attack. Sarcoidosis is most commonly seen in adults between the ages of 20 and 40. Northern Europeans and American blacks are the most susceptible. It strikes males and females equally.

Causes

The cause remains unknown.

Signs/Symptoms

Mild cases of sarcoidosis can come and go without ever being detected. Fever, weight loss, and joint pain may be the first signs of its presence. If the lungs are affected, you may experience shortness of breath and coughing. Signs of sarcoidosis in the skin include raised, tender, red bumps; flat, raised patches; and lumps just under the skin.

Care

Unless the disease causes severe symptoms, treatment may not be necessary. The condition typically disappears on its own after two or three years.

For acute cases, the recommended treatment is steroid medications, typically taken for 18 to 24 months. If you are prescribed steroids, your doctor will continue to closely monitor your health---through chest x-rays, pulmonary function tests, and blood tests---for several years after the drug therapy is discontinued for signs of a relapse. Relapses occur in about 50 percent of cases, usually within three to six months after the steroid treatment has been stopped. If the condition becomes chronic, drug therapy may last for several years.

Risks

Fatalities from sarcoidosis are relatively rare (less than 3 percent). Respiratory failure due to scarring in the lungs is the most common cause of death. Bleeding in the lungs due to infection is the next most common cause. If the condition forms in or close to the heart, it can cause heart failure or potentially fatal irregularities of the heartbeat.

If the disorder affects your eyes, unchecked inflammation can block fluid drainage, causing glaucoma (high pressure in the eyeballs) that ultimately leads to blindness.

Sarcoidosis can also cause high levels of calcium to accumulate in the blood and urine. If left untreated, the excess calcium can cause kidney stones, and eventually kidney failure.

Although sarcoidosis often affects the liver, it rarely leads to significant liver problems or jaundice.

WHAT YOU SHOULD DO

• Steroid treatment poses risks of its own, so you shouldn't expect it as a matter of course. Mild cases are usually better left untreated. The doctor will resort to steroids only if the condition threatens serious damage.
• If steroids or other medications are prescribed, be sure to take them exactly as directed, even if you feel well and the symptoms subside. If you feel the medication is not working, talk to your doctor. Do not skip dosages or quit taking the drugs on your own.
• If the disorder manifests as skin blemishes, keep the area clean.
• Eat a well balanced diet and do not skip meals. To help prevent kidney stones, be sure to drink 8 to 10 large glasses of water each day.

Call Your Doctor If...

• You experience pain in or around your eye or your eye becomes dry or red.
• You develop pain in your joints, especially in your hands or feet.

Seek Care Immediately If...

• You continue to experience shortness of breath or coughing after beginning drug therapy.
• You experience any loss of vision.
• You suffer poor appetite, nausea, vomiting, extreme thirst, or excessive urination.