This is an uncommon disease of unknown cause, in which clumps of immune cells called “granulomas” can invade practically any organ. The most common is the lung, affected in 90% of patients, who may have cough or shortness of breath. However, most patients often have no symptoms. On chest x-ray, large lymph nodes (like “swollen glands”) in the center of the lungs (the “hilum”) are key to diagnosis.
Other organs may show symptoms, such as:
- Joints: Swelling, especially if both ankles
- Skin lumps, large or small, various colors, usually on face or upper body, or in tattoos
- Eye: Dry eyes, recurrent redness & irritation, blurry vision
- Shortness of Breath
- Swelling of the liver, spleen, and lymph nodes
- Kidney stones, and loss of kidney function
If we ever find a high ESR (Sed Rate) or CRP on a blood test in someone with any of the above symptoms which we cannot easily diagnose, we’d get a chest x-ray and find classical abnormalities mentioned above. A blood test for “Angiotensin Converting Enzyme” may be high, but there are false-positives & -negatives. Diagnosis is made by biopsy, either of a skin lump, a lymph node, or maybe of the lung. Most patients with sarcoidosis do well; mortality may be 5% without treatment. Most disability and death occur from lung complications. The most common treatment is steroids, which suppress the immune system to prevent granulomas from forming.