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Diseases

Genetic and Rare Diseases Information Center (GARD)

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Sarcoidosis

*


* Not a rare disease
Other Names for this Disease
  • Sarcoid of Boeck
  • Schaumann's disease
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Your Question

I have been diagnosed with sarcoidosis. This condition has caused me severe pain and I wish to learn anything that might be useful to share with my doctors. Could this condition be the result of working in a hot silk-screen paint shop? Will I ever get over this condition? How can I manage the symptoms?

Our Answer

We have identified the following information that we hope you find helpful. If you still have questions, please contact us.

What is sarcoidosis?

Sarcoidosis is an inflammatory disease characterized by the development and growth of tiny lumps of cells called granulomas. If these tiny granulomas grow and clump together in an organ, they can affect how the organ works, leading to the symptoms of sarcoidosis.[1] The granulomas can be found in almost any part of the body, but occur more commonly in the lungs, lymph nodes, eyes, skin, and liver.[1][2][3] Although no one is sure what causes sarcoidosis, it is thought by most scientists to be a disorder of the immune system.[3] The course of the disease varies from person to person. It often goes away on its own, but in some people symptoms of sarcoidosis may last a lifetime. For those who need treatment, anti-inflammatory medications can help.[2]
Last updated: 3/30/2010

What symptoms are associated with sarcoidosis?

The disease can appear suddenly and disappear, or it can develop gradually and go on to produce symptoms that come and go, sometimes for a lifetime. As sarcoidosis progresses, small lumps, or granulomas, appear in the affected tissues. In the majority of cases, these granulomas clear up, either with or without treatment. In the few cases where the granulomas do not heal and disappear, the tissues tend to remain inflamed and become scarred (fibrotic).[1][4]

Shortness of breath (dyspnea) and a cough that won't go away can be among the first symptoms of sarcoidosis. Sarcoidosis can also show up suddenly with the appearance of skin rashes. Red bumps (erythema nodosum) on the face, arms, or shins, and inflammation of the eyes are also common symptoms. It is not unusual, however, for sarcoidosis symptoms to be more general. Weight loss, fatigue, night sweats, fever, or just an overall feeling of ill health can also be clues to the disease.[1][4]

Ninety percent of the cases of sarcoidosis are found in the lungs.[1][4]

Other commonly affected sites are [1][4]:

  •   Skin
  •   Liver
  •   Lymph glands
  •   Spleen
  •   Eyes
  •   Nervous system, including the brain
  •   Musculoskeletal system (the muscles and bones in the body)
  •   Heart
  •   Kidneys
Last updated: 2/10/2009

What causes sarcoidosis?

No one yet knows what causes sarcoidosis. It is thought by most scientists to be a disorder of the immune system, where the body's natural defense system malfunctions. Some physicians believe that sarcoidosis may result from a respiratory infection caused by a virus. Others suspect that exposure to toxins or allergens in the environment is to blame.[4] It's also possible that some people have a genetic predisposition to developing sarcoidosis, which, when combined with an environmental trigger, produces the disease.[5] Studies are ongoing to investigate the genetic and environmental components of this disease.[4][5]

 


Last updated: 2/10/2009

Could sarcoidosis be caused by occupational exposure to chemicals in a silk screen paint shop?

Doctors think that sarcoidosis may occur when the immune system overreacts to an unknown toxin, drug or pathogen that enters the body through the airways during respiration.[2] Environmental antigens implicated include metals (eg, zirconium, aluminum, beryllium), organic dusts (eg, pine, pollen), and inorganic dusts (eg, clay, soil, talc).[5]

Since the exact cause of sarcoidosis is not fully understood, it is difficult to say whether a specific exposure might be to blame. We recommend that you discuss your concerns regarding your occupational exposure with your physicians.
Last updated: 2/10/2009

What treatment is available for sarcoidosis?

The treatment of sarcoidosis depends on [1][4][6]

  • the symptoms present
  • the severity of the symptoms
  • whether any of vital organs (e.g., your lungs, eyes, heart, or brain) are affected
  • how the organ is affected.

Some organs must be treated, regardless of your symptoms. Others may not need to be treated. Usually, if a patient doesn't have symptoms, he or she doesn't need treatment, and probably will recover in time. [1][4][6]

Currently, the drug that is most commonly used to treat sarcoidosis is prednisone.  When a patient's condition gets worse when taking prednisone or when the side effects of prednisone are severe in the patient, a doctor may prescribe other drugs.  Most of these other drugs are immune system suppresants.  This means that they prevent one's immune system from fighting things like bacteria and viruses.  These other drugs include: hydroxychloroquine (Plaquenil), methotrexate, azathioprine (Imuran), and cyclophosphamide (Cytoxan).  Other drugs being studied for possible use in treating sarcoidosis include:  etanercept (Enbrel), infliximab (remicaide), pentoxifylline, tetracycline, thalidomide.[1][4][6]

More detailed information about the treatment of sarcoidosis can be found at the following links:
http://www.stopsarcoidosis.org/sarcoidosis/treatment.htm
http://emedicine.medscape.com/article/1123970-treatment

Last updated: 2/11/2009

What is the prognosis for individuals affected by sarcoidosis?

The course of the disease is variable, but in about two-thirds of people with sarcoidosis, the condition resolves with no lasting consequences.[2][5] In some people, sarcoidosis can become chronic and lead to complications, including lung scarring, eye disease, skin disease, nervous system problems, fertility problems, heart and liver problems.[2] The mortality rate for sarcoidosis is 1-6%. In the United States, mortality is most commonly due to respiratory failure from pulmonary involvement, cardiac involvement, or neurosarcoidosis. Complications of therapy are additional causes of morbidity and mortality. Adverse prognostic factors include African American race, chronic cutaneous lesions, chronic uveitis, age at onset older than 40 years, cystic bone lesions, neurosarcoidosis, myocardial involvement, and stage III or IV pulmonary disease.[5] 
Last updated: 2/11/2009

References