Sarcoidosis - Symptoms & Treatment
A multisystemic, granulomatous disorder, sarcoidosis characteristically produces lymphadenopathy, pulmonary infiltration, and skeletal, liver, eye, or skin lesions. It occurs most often in young adults (ages 20 to 40). In the United States, sarcoidosis occurs predominantly among blacks and affects twice as many women as men.
Acute sarcoidosis usually resolves within 2 years. Chronic, progressive sarcoidosis, which is uncommon, is associated with pulmonary fibrosis and progressive pulmonary disability.
Sarcoidosis remains something of a medical mystery, but it's believed to result from an abnormal immune response. Just what triggers this response isn't known. Doctors do know that the disease often goes away on its own without treatment - usually within 2 to 3 years. Some people may have symptoms for a lifetime, however. And in rare cases sarcoidosis can be fatal.
If you have no signs or symptoms of sarcoidosis or only minor ones, your doctor may choose to take a wait-and-see approach. Treatment for severe cases is usually with the corticosteroid drug prednisone.
Although the cause of sarcoidosis is unknown, the following possible causes have been considered:
Signs and symptoms
Initial signs of sarcoidosis include arthralgia (in the wrists, ankles, and elbows), fatigue, malaise, and weight loss. Other clinical features vary according to the extent and location of fibrosis:
During a physical exam, physicians check for:
Asymptomatic sarcoidosis requires no treatment. However, sarcoidosis that causes ocular, respiratory, CNS, cardiac, or systemic symptoms (such as fever and weight loss) requires treatment with systemic or topical steroids, as does sarcoidosis that produces hypercalcemia or destructive skin lesions. Such therapy is usually continued for 1 to 2 years, but some patients may need lifelong therapy.
Other treatment includes a low-calcium diet and avoidance of direct exposure to sunlight in patients with hypercalcemia.
Many people with sarcoidosis recover completely. Others have only minor symptoms. But some people have more severe problems, including damage to their lungs or other organs. These suggestions may help make it easier to live with sarcoidosis:
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