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Sarcoidosis

What is Sarcoidosis?

Sarcoidosis is a multisystem disorder that occurs when granulomas or clumps of inflammatory cells form in various organs, which results in organ inflammation. This disease commonly affects the lungs, lymph glands, eyes, liver, skin, heart and spleen. The inflammation may change the structure and possibly affect the function of the affected organ or organs.

The cause of sarcoidosis is unknown, but researchers believe it results from the body’s immune system responding to an unknown substance such as infectious agents, chemicals, dust and potential abnormal reaction to the body’s own proteins called self proteins.

What are the symptoms of sarcoidosis?

Sarcoidosis symptoms vary depending on which organ or organs are affected. In some cases, sarcoidosis develops gradually, producing symptoms that last for years, while in some cases, symptoms may appear suddenly and then disappear just as quickly. Some people with sarcoidosis may not experience any symptoms, making the disease difficult to diagnosis and may also result in a delay in diagnosis.

The most common symptoms of sarcoidosis include:

• A cough that won’t go away
• Shortness of breath
• Red bumps or patches on the skin or under the skin
• Fever, weight loss, fatigue, night sweats and a general feeling of ill health

Other disease characteristics include:

• Swollen and painful joints
• Enlarged lymph glands in the neck, armpits and groin
• Hoarse voice
• Pain in the hands, feet or other bony parts of the body due to the formation of cysts in the bones
• The formation of kidney stones
• Red and teary eyes
• Blurred vision
• Development of abnormal or missed heartbeats
• Inflammation of the covering of the heart
• Heart failure
• Nervous system effects include hearing loss, meningitis, seizures or psychiatric disorders such as depression or dementia.

Symptomatic sarcoidosis is not very common in children

Children between 8 and 15 years may present with multisystem disease that’s similar to what’s commonly seen in adults.

Younger children usually present with arthritis, a skin rash and uveitis (inflammation in part of the eye) without apparent lung involvement.

What are the treatment options for sarcoidosis?

In many cases, sarcoidosis, especially cutaneous sarcoidosis, may resolve on its own without any treatment. This happens when there are no symptoms experienced or there are only mild symptoms experienced. Depending on the severity and extent of the condition, Dr Ambaram may recommend medications such as corticosteroids, medications to help suppress the immune system like methotrexate, antimalarial agents or a trial of tumour necrosis factor (TNF) therapy for severe cases that don’t respond to conventional treatment. Physical therapy may also be recommended to reduce fatigue and improve muscle strength.