Pulmonary Conditions & Diseases: Sarcoidosis

Sarcoidosis is a multi-system autoimmune disease that can cause inflammation in several areas of the body. Normally, your body’s immune system attacks any substance that it senses is harmful and causes an inflammatory response in the body that goes away after the harmful substance is eliminated. In sarcoidosis, the immune system will cause inflammation even when there is no harmful substance present in the body for it to attack. In sarcoidosis the unregulated immune system overreacts, resulting in granulomas (clumps of cells) being deposited throughout the body. These clumps of cells can affect the tissue in which they were deposited, leading to issues in those affected locations, most commonly the lungs.

What are the signs and symptoms?

While some people with sarcoidosis have no symptoms or mild symptoms, others can have moderate to severe symptoms which may require treatment. The symptoms typically reflect which organ or tissue is affected. Most commonly, sarcoidosis affects the lungs and some typical symptoms include:

• Cough
• Shortness of breath
• Wheezing
• Chest pain or discomfort

Other common symptoms include:

• Fever
• Weight loss
• Joint aches
• Fatigue
• Swollen lymph nodes
• Skin changes
• Night sweats

What are risk factors and triggers?

The exact cause for sarcoidosis is unknown at this time. Our current understanding is that your immune system may be triggered by something in your environment particularly if you have a genetic predisposition (family history) to the disease. These possible environmental triggers include:

• Dust
• Mold/mildew
• Chemicals
• Metals
• Infections (viruses, bacteria)

There are some who are at greater risk for having these disease, these include:

• Those with a family history of sarcoidosis
• African American descent
• Northern European descent
• Ages 20-50
• Work/live in an environment with exposure to chemicals, molds, mildew, metal or insecticides.

How is it diagnosed?

There is no one definitive testing available for sarcoidosis however we use several different tools to help make the diagnosis. These may include:

• Medical history
• Physical exam
• Imaging
  •CT scan
  •Chest X-ray
  •MRI
  •PET scan
• Lung function tests
  •These check for breathing issues that could be related to sarcoidosis
• Biopsy
  •This is a sample of tissue that is removed from the body. Depending on the affected area, the place we get a biopsy can differ such as lung tissue, a lymph node, or a skin lesion.
• Other testing may be done in order to make sure there are no complications from the disease outside of the lungs. These tests may include:
  •Eye exams (typically once yearly)
  •MRI of the heart or brain
  •Electrocardiogram (EKG or ECG)
  •Echocardiogram (ultrasound of the heart)

How is it treated?

There is no specific treatment for sarcoidosis and not everyone who is diagnosed with sarcoidosis requires treatment. The decision on when to treat and how to treat sarcoidosis is made in collaboration with our board certified pulmonologists and may vary depending on your degree of symptoms as well as other factors. Typically if you have no symptoms or mild symptoms no treatment is required. However, if your symptoms begin to bother you or are severe, you may be prescribed medications to help relieve the inflammation and symptoms you are experiencing. These medications may include:

• Steroids – Prednisone is a steroid that reduces inflammation that is related to sarcoidosis
• Immunosuppressive drugs
• Inhalers – medications that help you breathe if sarcoidosis affects your lungs
• Smoking cessation – It is important to stop smoking if you are diagnosed with sarcoidosis as smoking may worsen the disease

Our board certified pulmonologists will work closely with you in order to ensure personalized care with comprehensive treatment plans, counseling, medication education, and testing.