Sarcoidosis

Cause

The exact cause of sarcoidosis is not yet clear. Research has shown that heredity and environmental factors are believed to play a role. There are a number of known substances that could lead to a response of the immune system in people with sarcoidosis: beryllium, aluminum, titanium, zirconium, glass wool, rockdust, talc, chalk and flour. Sarcoidosis is not contagious.

Symptoms

The symptoms of sarcoidosis vary significantly from patient to patient and depend mainly on the organs and tissues in which inflammation is or has been present. The lungs and lymph nodes are the organs that are most commonly affected, but the disease can also occur in other organs and tissues, such as the skin, eyes, heart, bone marrow, spleen, liver, kidneys and all structures that have to do with the nervous system, the musculoskeletal system, the endocrine system and reproductive organs.
Common signs and symptoms are:

• Fatigue.
• Shortness of breath.
• Cough.
• Joint problems.
• Muscle pain.
• Fever.
• Nosebleeds.
• Loss of smell.
• Difficulty concentrating.
• Eye problems, such as uveitis, dry eyes and burning eyes.
• Skin injuries (swelling and painful red or purple spots).
• Headache.
• Weight loss.
• Dizziness.
• Depression.
• Sleeping problems.
• Dry mouth.
• Heart problems or heart rhythm disorders.

Diagnosis

The diagnosis of sarcoidosis is often made based on the symptoms and physical examination. Several blood tests and imaging studies are done in order to confirm the diagnosis. Of the imaging studies, normal X-ray photographs of the chest are the best method to determine whether there is sarcoidosis. Often, people don’t suffer from the disease when it occurs and the disease is only detected by defects demonstrated on a chest X-ray. In some patients, additional examinations are needed, such as CT scans of the chest, lung scan, pulmonary function tests and organ biopsy.

Treatment

Sarcoidosis can currently not be cured. Because the disease may occur in various organs and tissues, the treatment of each patient is different. Not every patient requires, for example, treatment with medication. Treatment of sarcoidosis is possible with:

• Corticosteroids. The corticosteroids help suppress the inflammation.
• Anti-inflammatory drugs or NSAIDs. These are prescribed for pain in joints and/or muscles and reduce fever.
• Immunosuppressants. These drugs suppress the immune system.
• Biologicals. This is a relatively new kind of agent that blocks particular proteins in the immune system, the so-called cytokines or messenger proteins. As a result, the inflammatory process is blocked immediately.
• Physical therapy. This can help to keep the best possible condition, so the endurance improves.
• Remedial therapy. This can be used to keep the body as supple as possible. It can reduce joint and muscular problems due to sarcoidosis.
• Respiratory therapy. If a person is easily tired and often short of breath, breathing can be too rapidly and too shallow, in an attempt to get more oxygen. Yet that isn’t the proper way to breathe. In so-called respiratory therapy, the patient learns to breathe correctly.
• Massage. Reduces problems of pain and musclular problems in superficial muscles.

Prognosis

The prognosis varies. Most people with sarcoidosis recover spontaneously within one to two years. In ten to fifteen percent of the cases, the acute stage of the disease passes into a chronic. In negroid patients, the disease often appears to run longer and more severe. An age of more than forty years often leads to a delay of spontaneous recovery.

Considerations

• Sarcoidosis requires no special diet. Eat varied, not too much, use less saturated fat, eat plenty of vegetables, fruits and bread and handle food safely.
• Get regular exercise, as this prevents osteoporosis, keeps joints supple, strengthens muscles, is good for the condition, strengthens heart and lungs, reduces body fat and lowers cholesterol.

Facts

• Sarcoidosis was first described in 1877 by the English doctor Jonathan Hutchinson.
• The term ‘sarcoidosis’ is derived from the Greek word sarcoid (meat-like). The suffix -osis represents disease.
• The name ‘Besnier-Boeck-Schaumann disease’ refers to the doctors who have done the most initial research: the French doctor Ernest Henri Besnier, the Norwegian doctor Caesar Peter Møller Boeck and the Swedish doctor Jörgen Nilsen Schaumann.
• The prevalence of sarcoidosis is estimated at 0.05%.
• The disease is most common in people aged 20 to 40 years.