Sarcoidosis

Sarcoidosis is an inflammatory disease that affects multiple organs in the body, but mostly the lungs and lymph glands. This inflammation produces tiny lumps of cells in various organs in the body. The lumps are called granulomas because they look like grains of sugar or sand. They are the classic sign of sarcoidosis, and as they are very small, they can only be seen with a microscope.

These tiny granulomas can grow and clump together, making small and large groups of lumps. If many granulomas form in an organ, they can change its normal structure and possibly affect how the organ works. Sarcoidosis can affect many organs, but it usually starts in the lungs or the lymph nodes.

The exact cause of sarcoidosis is not known, but researchers believe that it is caused by an abnormal immune response. The disease can appear suddenly and then disappear, or it can develop gradually and produce symptoms that come and go for a lifetime.

Symptoms

While some patients with sarcoidosis may show no signs of the disease, there are many associated symptoms.

• General
  • Dry mouth
  • Fever
  • Weight loss
  • Fatigue
  • Night sweats
  • Swollen and painful joints
  • Nasal stuffiness
  • Hoarse voice
  • Pain in the hands, feet, or other bony areas
  • General feeling of ill health
• Skin
  • Reddish bumps or patches on the skin or under the skin
• Lungs
  • Shortness of breath
  • Cough that won’t go away
  • Chest pain
• Eyes
  • Red or teary eyes
  • Blurred vision
• Neurologic/Nervous System
  • Gait problems
  • Headache
  • Meningitis
• Lymph glands
  • Enlarged lymph glands in the chest around the lungs and elsewhere in the body
• Cardiac
  • Development of abnormal or missed beats (arrhythmias), inflammation of the covering of the heart (pericarditis), or heart failure
• Kidney
  • Kidney stones

Diagnosing Sarcoidosis 

Because the symptoms may occur in other diseases and there is no single lab test that can diagnose the disease, diagnosis of sarcoidosis may be difficult. Further, determining the presence of granulomas isn’t enough, as they do not differ from granulomas that occur in other diseases. Diagnosis is typically achieved following a careful evaluation by clinicians with experience in diagnosis, and often includes the following tests:

Physical Exam

Your physician will ask you a series of questions and is likely to do a physical exam. The physical exam will including examining any specific areas of concern, especially as they relate to the reason for your visit to the office.

Personal and Family Medical History

Your doctor will likely ask you a series of questions relating to your personal medical history and your family's medical history.

Imaging Tests

Doctors may perform one or more of the follow imaging tests: Bone x-rays, CT scan, MRI, PET scan.

Pulmonary Function Test (PFT)

To understand how well your lungs are working, your physician may order a series of pulmonary function tests. With each breath you take in and breathe out, information is recorded about how much air your lungs take in, how the air moves through your lungs and how well your lungs deliver oxygen to your bloodstream.

Surgical (Excisional) Lymph Node Biopsy

The physician removes an enlarged lymph node through a small cut in the skin. If the lymph node is close to the surface of the skin, a local anesthetic will be used to numb the area being biopsied. If it is located deep under the skin, you may be given drugs to make you drowsy or be put to sleep (using general anesthesia). Surgical lymph node biopsies are generally performed if the lymph node’s size indicates the melanoma has spread, but an FNA was not performed or did not yield conclusive results.

Biopsy

Any suspicious mass of tissue or tumor is subject to a biopsy, or removal of cells from the mass. This is the only technique that can confirm the presence of cancer cells. The doctor will use a general or local anesthetic depending on the location of the mass, and then remove a sample of tissue to send to the lab. The sample is sent to a pathologist, a physician who is an expert at identifying diseased cells in tissue samples. Very often, a few stiches are used to help the area heal, and tenderness is felt for a short period of time.

Frequently Asked Questions

I think I might have sarcoidosis. What should I do?

Because the signs and symptoms of sarcoidosis can resemble other diseases, the diagnosis of sarcoidosis can be difficult to make. The Sarcoidosis Program at BMC can help determine if you have the disease. Because it is a multidisciplinary Program, it can offer a comprehensive plan of care through a team of specialists who excel at treating the various organ systems that sarcoidosis can affect. Because the disease may disappear and reappear over a lifetime, the Sarcoidosis Program at BMC is committed to long-term, quality care and follow-up.

Is there a cure for sarcoidosis?

There is no cure for sarcoidosis, but the disease may get better on its own over time or with medication.

Is sarcoidosis cancer?

No, sarcoidosis is not a form of cancer, but it can be mistaken for cancer until proper diagnosis is attained.

Is sarcoidosis contagious?

No, it is not contagious. No one can catch the disease from you.

Is sarcoidosis a genetic disease? Will my children get it?

Within some families, the presence of sarcoidosis in a close relative has been shown to increase the chance of getting the disease. Multiple genes have been identified that affect the chances of getting sarcoidosis, and it is the combination of these genes that come together to influence the likelihood of getting sarcoidosis. Some of your genes will be passed to offspring, which may account for the elevated risk within families. Despite this, there is currently no screening test to identify who is at risk, and the likelihood of a family member getting the disease is still so low, that screening for sarcoidosis is not currently recommended.

Do I need to alter my diet in any way?

Not unless the sarcoidosis is causing high blood calcium levels. About 5% of people with sarcoidosis do have high blood calcium levels. For these patients, a reduction in intake of calcium rich foods (such as dairy products, oranges, broccoli, canned salmon, and collard greens), vitamins containing calcium, and vitamin D becomes necessary, as does avoiding excessive sun exposure.