Sarcoidosis disease usually leads to inflammation in the body tissues also can occur in any body organ, and starts in the lymph nodes or lungs. Granulomas is an abnormal mass or nodules, may change the regular structure and also the performance of the organs affected.
1. What is it
Sarcoidosis, or sarcoid, is a disease in which certain inflammatory cells clump together and form nodules known as granulomas in various parts of the body. The most common organs to be affected by sarcoidosis are the lungs, the skin, and the eyes, although in some people almost any part of the body can be involved.
In most cases, the body’s immune system heals the granulomas over a few years. Sometimes, for reasons that are not understood, this does not happen and scar tissue is formed. This is called fibrosis and can result in permanent damage. Sarcoidosis causes cells to group together into clumps called “granulomas.”
2. Who gets Sarcoidosis
Sarcoidosis is an uncommon condition, although the number of people diagnosed varies from country to country. It is difficult to be sure how many people have sarcoidosis throughout the world, as many do not know they have it and sometimes it can be mistaken for other diseases.
In the UK, about 3,000 new cases of sarcoidosis are diagnosed each year. It can affect people of any age, but is more common in young adults and is slightly more common in women. In some populations, such as Afro-Caribbean, Irish and Swedish people, it can affect up to 60 out of every 100,000 people.
3. Causes of Sarcoidosis
Nobody knows the cause of sarcoidosis even though much scientific c research is being carried out to answer this question. It is also not clear why sarcoidosis affects different people in different ways. Some scientists think it may be due to an environmental toxin or a virus that triggers the body to react in a certain way.
A person’s individual genetic make-up may also be important. Despite these uncertainties, if you are a patient who has been diagnosed with sarcoidosis, you can be reassured by some of the following facts:
• The majority of people with sarcoidosis get better without specific treatment within
12 to 18 months and lead perfectly normal lives
• Sarcoidosis is not infectious; you cannot catch it and it cannot be passed between people
• Sarcoidosis is not a form of cancer
4. What are the Symptoms
• 40% of cases have respiratory symptoms Shortness of breath and a dry cough
• A fly u-like illness with fever, tiredness and joint pains
• A painful red rash usually occurring on the arms or legs
• 25% of cases affect the eyes. Eye irritation and visual problems
• Swollen glands, which can be felt in the neck or around the face
90% of cases affect the lungs and lymph nodes.
25% of cases affect the skin.
5. Having Sarcoidosis
It can be discovered by chance, for example, when a chest X-ray is done for other reasons, such as for an employment medical.
The diagnosis of sarcoidosis can be difficult and may take time because other diseases closely resemble sarcoidosis. In some cases, tissue samples or biopsies are needed. These are usually taken from the lungs, glands in the neck or chest, or from the skin.
If a biopsy is needed it will usually be straightforward and be done under local anesthetic. Tests in hospital help to show how severe the disease is and what parts of the body are affected. Many people do not need treatment and can be simply monitored regularly. Your doctor will discuss with you whether you need treatment for your sarcoidosis and advise you on the best options.
Systemic treatment is usually recommended when sarcoidosis affects the brain or heart and when sarcoidosis is affecting lung function. For eye and skin involvement, treatment decision depends on the extent of the area involved. The most common drug used is prednisolone (a steroid).
Sarcoidosis responds very well to steroids, although they do not cure the disease, which may relapse after the steroids are stopped. Steroids can also cause side effects, such as weight gain, diabetes, thinning of the bones, and thinning of the skin and easy bruising.
Therefore, the decision to use steroids must be carefully considered and your doctor will help you balance the risk and benefit ts of treatment. If a decision is made to start steroids, your doctor will help you to find the lowest dose of steroids that control your symptoms by gradually lowering the dose you take: this is called tapering.
There are other drugs available, but these are generally less effective than steroids. With good medical care, most cases of sarcoidosis are not severe and do not cause lasting damage to the
body. When treatment is needed, however, it is important to understand all of your options.
Blood analyses evaluate the number and types of blood cells in the body. The tests also measure the blood levels of various proteins, such as ACE (see page 2), which are known to be involved in immunological activities, as well as increases in calcium levels. Additionally, they can show liver, kidney, and bone marrow abnormalities that can occur with sarcoidosis.
Pulmonary Function Test
Pulmonary function tests are used to monitor the course of the disease in the lungs. These tests are safe and easy to do. The results are compared over time. One pulmonary function test uses
a “spirometer,” a device that measures how much and how fast a person can blow air out of the lungs after taking a deep breath.
This amount will be less than normal if there is significant inflammation and/or scarring in the lung. Another test measures lung volume, which indicates how much air the lungs can hold. In some patients, the lungs may shrink or contract due to sarcoidosis, and the lung volumes will be smaller than normal.
Other tests check for diffusing capacity, or how well a gas moves into the bloodstream from the lungs. Sarcoidosis makes it harder for oxygen to move from the lungs into the bloodstream. In one test, a device called a pulse oximeter is placed on the finger to give the doctor a rough idea of the level (or saturation) of oxygen in the patient’s blood.
An arterial blood gas test is a more accurate way to check the level of oxygen in the bloodstream. Blood from an artery (usually in the wrist) is used because it has passed through the lungs and taken up oxygen. The blood is then analyzed for its oxygen and carbon dioxide.
All persons diagnosed with sarcoidosis should have an eye test done by an ophthalmologist (eye doctor). Even if there are no symptoms of the disease in the eyes, the results
of the test can be used to help monitor the disease.
If eye symptoms appear, the test will be repeated during treatment. It also should be repeated periodically for those treated for their sarcoidosis with a particular drug called chloroquine or hydroxychloroquine (Plaquenil) that can sometimes cause side effects related to vision.
Also, patients receiving corticosteroids need to be seen by an ophthalmologist to check for signs of cataract development. For the eye examination, the doctor looks into the eye for abnormalities and does tests to check for color blindness.