April shines spotlight on sarcoidosis awareness

Congress declared April as National Sarcoidosis Awareness Month in 2008, but have you heard of it? The multisystem disease is rare, and only about 200,000 people in the United States have it.
In some cases, it can be life-threatening, and it often shows no signs or symptoms.

What is sarcoidosis?

Sarcoidosis is an inflammatory disease that is characterized by the formation of tiny clumps of inflammatory cells, known as granulomas, in at least one, and sometimes more, organs in the body. If too many clumps form, the structure and function of the organ can be affected. In 90% of cases, it will affect the lungs.

Symptoms

Depending on which organ is affected, sign and symptoms can vary widely, or there can be no symptoms at all.

The symptoms can include, but are not limited to:

  • Fever
  • Enlarged lymph nodes
  • Swollen and painful joints
  • Raised, red and tender bumps on the skin, typically on the front of the legs and often making nearby joints swollen and painful.
  • Fatigue
  • Unexplained weight loss
  • Night sweats
  • Overall feeling of sickness
  • Irregular heart beat
  • Swollen legs
  • Headaches
  • Visual problems
  • Weakness or numbness in an arm, leg or part of the face
  • Discoloration of the nose, cheeks, lips and ears
  • Scaly-appearing skin rash
  • Joint pain
  • Muscle swelling and soreness
  • Arthritis
  • Burning, itching, tearing or pain in the eyes
  • Red eyes
  • Sensitivity to light
  • Blurred vision
  • Shortness of breath
  • Wheezing
  • Chronic cough

Diagnosis

While people between the ages of 20 and 70 can be diagnosed with sarcoidosis, the average age in the United States is 55. Since there is not one specific test to pinpoint sarcoidosis, doctors often must rule out other possible diseases.

Doctors may arrive at the diagnosis after doing some of the following tests:

  • Chest X-ray
  • Computerized tomography, or CT, scans
  • Lung function tests, also known as pulmonary function tests or PFTs
  • Lung biopsy
  • Other biopsies
  • Blood tests
  • Magnetic resonance imaging, or MRI
  • Nuclear imaging
  • Positron emission tomography, or PET scan
  • Heart rhythm monitoring
  • Echocardiogram

Prognosis and treatment

About 60% of people with the disease will see the granulomas disappear over a two- to five-year period, leading to remission. Those patients will not likely experience a relapse.

In about 40% of patients, the disease can be more progressive, causing scars to form in the affected organs. Those patients benefit more by seeing a doctor who regularly sees patients with the disease.

The mortality rate is 5%. Cases involving the heart or that cause severe scarring in the lungs will warrant additional concerns. Lung and heart transplants, however, have proven to be successful in improving the outcome for those with advanced sarcoidosis.

While plenty of cases require no treatment, others may get treatment through medications. Those include:

  • Corticosteroids
  • Immune system suppressant medication
  • Antimalarial drugs

In some cases, people with advanced lung sarcoidosis will receive oxygen therapy.

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