Question: What causes Sarcoidosis ?
Answer: The cause of sarcoidosis isn't known. More than one factor may play a role in causing the disease. Some researchers think that sarcoidosis develops if your immune system responds to a trigger, such as bacteria, viruses, dust, or chemicals. Normally, your immune system defends your body against foreign or harmful substances. For example, it sends special cells to protect organs that are in danger. These cells release chemicals that recruit other cells to isolate and destroy the harmful substance. Inflammation occurs during this process. Once the harmful substance is gone, the cells and the inflammation go away. In people who have sarcoidosis, the inflammation doesn't go away. Instead, some of the immune system cells cluster to form lumps called granulomas in various organs in your body. Genetics also may play a role in sarcoidosis. Researchers believe that sarcoidosis occurs if: You have a certain gene or genes that raise your risk for the disease And You're exposed to something that triggers your immune system Triggers may vary depending on your genetic makeup. Certain genes may influence which organs are affected and the severity of your symptoms. Researchers continue to try to pinpoint the genes that are linked to sarcoidosis.
Source: NHLBI

Question: Who is at risk for Sarcoidosis? ?
Answer: Sarcoidosis affects people of all ages and races. However, it's more common among African Americans and Northern Europeans. In the United States, the disease affects African Americans somewhat more often and more severely than Whites. Studies have shown that sarcoidosis tends to vary amongst ethnic groups. For example, eye problems related to the disease are more common in Japanese people. Lofgren's syndrome, a type of sarcoidosis, is more common in people of European descent. Lofgren's syndrome may involve fever, enlarged lymph nodes, arthritis (usually in the ankles), and/or erythema nodosum. Erythema nodosum is a rash of red or reddish-purple bumps on your ankles and shins. The rash may be warm and tender to the touch. Sarcoidosis is somewhat more common in women than in men. The disease usually develops between the ages of 20 and 50. People who have a family history of sarcoidosis also are at higher risk for the disease. Researchers have looked for a link between sarcoidosis and exposure to workplace and environmental factors. However, no clear link has been found.
Source: NHLBI

Question: What are the symptoms of Sarcoidosis ?
Answer: Many people who have sarcoidosis have no signs or symptoms or mild ones. Often, the disease is found when a chest x ray is done for another reason (for example, to diagnose pneumonia). The signs and symptoms of sarcoidosis vary depending on which organs are affected. Signs and symptoms also may vary depending on your gender, age, and ethnic background. (For more information, go to "Who Is at Risk for Sarcoidosis?") Common Signs and Symptoms In both adults and children, sarcoidosis most often affects the lungs. If granulomas (inflamed lumps) form in your lungs, you may wheeze, cough, feel short of breath, or have chest pain. Or, you may have no symptoms at all. Some people who have sarcoidosis feel very tired, uneasy, or depressed. Night sweats and weight loss are common symptoms of the disease. Common signs and symptoms in children are fatigue (tiredness), loss of appetite, weight loss, bone and joint pain, and anemia. Children who are younger than 4 years old may have a distinct form of sarcoidosis. It may cause enlarged lymph nodes in the chest (which can be seen on chest x-ray pictures), skin lesions, and eye swelling or redness. Other Signs and Symptoms Sarcoidosis may affect your lymph nodes. The disease can cause enlarged lymph nodes that feel tender. Sarcoidosis usually affects the lymph nodes in your neck and chest. However, the disease also may affect the lymph nodes under your chin, in your armpits, or in your groin. Sarcoidosis can cause lumps, ulcers (sores), or areas of discolored skin. These areas may itch, but they don't hurt. These signs tend to appear on your back, arms, legs, and scalp. Sometimes they appear near your nose or eyes. These signs usually last a long time. Sarcoidosis may cause a more serious skin condition called lupus pernio. Disfiguring skin sores may affect your nose, nasal passages, cheeks, ears, eyelids, and fingers. These sores tend to be ongoing. They can return after treatment is over. Sarcoidosis also can cause eye problems. If you have sarcoidosis, having an annual eye exam is important. If you have changes in your vision and can't see as clearly or can't see color, call 911 or have someone drive you to the emergency room. You should call your doctor if you have any new eye symptoms, such as burning, itching, tearing, pain, or sensitivity to light. Signs and symptoms of sarcoidosis also may include an enlarged liver, spleen, or salivary glands. Although less common, sarcoidosis can affect the heart and brain. This can cause many symptoms, such as abnormal heartbeats, shortness of breath, headaches, and vision problems. If sarcoidosis affects the heart or brain, serious complications can occur. Lofgren's Syndrome Lofgren's syndrome is a classic set of signs and symptoms that occur in some people when they first have sarcoidosis. Signs and symptoms may include: Fever. This symptom only occurs in some people. Enlarged lymph nodes (which can be seen on a chest x ray). Arthritis, usually in the ankles. This symptom is more common in men than women. Erythema nodosum. This is a rash of red or reddish-purple bumps on your ankles and shins. The rash may be warm and tender to the touch. This symptom is more common in women than men. Sarcoidosis Signs and Symptoms
Source: NHLBI

Question: How to diagnose Sarcoidosis ?
Answer: Your doctor will diagnose sarcoidosis based on your medical history, a physical exam, and test results. He or she will look for granulomas (inflamed lumps) in your organs. Your doctor also will try to rule out other possible causes of your symptoms. Medical History Your doctor may ask you detailed questions about your medical history. For example, he or she may ask whether you: Have a family history of sarcoidosis. Have had any jobs that may have raised your risk for the disease. Have ever been exposed to inhaled beryllium metal. (This type of metal is used to make aircrafts and weapons.) Have had contact with organic dust from birds or hay. Exposure to beryllium metal and organic dust can cause inflamed lumps in your lungs that look like the granulomas from sarcoidosis. However, these lumps are signs of other conditions. Physical Exam Your doctor will check you for signs and symptoms of sarcoidosis. Signs and symptoms may include red bumps on your skin; swollen lymph nodes; an enlarged liver, spleen, or salivary glands; or redness in your eyes. Your doctor also will check for other causes of your symptoms. Your doctor may listen to your lungs and heart. Abnormal breathing or heartbeat sounds could be a sign that sarcoidosis is affecting your lungs or heart. Diagnostic Tests You may have tests to confirm a diagnosis and to find out how sarcoidosis is affecting you. Tests include a chest x ray, lung function tests, biopsy, and other tests to assess organ damage. Chest X Ray A chest x ray is a painless test that creates pictures of the structures inside your chest, such as your heart and lungs. The test may show granulomas or enlarged lymph nodes in your chest. About 95 percent of people who have sarcoidosis have abnormal chest xrays. Lung Function Tests Lung function tests measure how much air you can breathe in and out, how fast you can breathe air out, and how well your lungs deliver oxygen to your blood. These tests can show whether sarcoidosis is affecting your lungs. Biopsy Your doctor may do a biopsy to confirm a diagnosis or rule out other causes of your symptoms. A biopsy involves taking a small sample of tissue from one of your affected organs. Usually, doctors try to biopsy the organs that are easiest to access. Examples include the skin, tear glands, or the lymph nodes that are just under the skin. If this isn't possible, your doctor may use a positron emission tomography (PET) scan to pinpoint areas for biopsy. For this test, a small amount of radioactive substance is injected into a vein, usually in your arm. The substance, which releases energy, travels through the blood and collects in organs or tissues. Special cameras detect the energy and convert it into three-dimensional (3D) pictures. If lung function tests or a chest x ray shows signs of sarcoidosis in your lungs, your doctor may do a bronchoscopy (bron-KOS-ko-pee) to get a small sample of lung tissue. During this procedure, a thin, flexible tube is passed through your nose (or sometimes your mouth), down your throat, and into the airways to reach your lung tissue. (For more information, go to the Health Topics Bronchoscopy article.) Other Tests To Assess Organ Damage You also may have other tests to assess organ damage and find out whether you need treatment. For example, your doctor may recommend blood tests and/or an EKG (electrocardiogram). If youre diagnosed with sarcoidosis, you should see an ophthalmologist (eye specialist), even if you dont have eye symptoms. In sarcoidosis, eye damage can occur without symptoms.
Source: NHLBI

Question: What are the treatments for Sarcoidosis ?
Answer: Not everyone who has sarcoidosis needs treatment. Sometimes the disease goes away on its own. Whether you need treatment and what type of treatment you need depend on your signs and symptoms, which organs are affected, and whether those organs are working well. If the disease affects certain organssuch as your eyes, heart, or brainyou'll need treatment even if you don't have any symptoms. In either case, whether you have symptoms or not, you should see your doctor for ongoing care. He or she will want to check to make sure that the disease isn't damaging your organs. For example, you may need routine lung function tests to make sure that your lungs are working well. If the disease isn't worsening, your doctor may watch you closely to see whether the disease goes away on its own. If the disease does start to get worse, your doctor can prescribe treatment. The goals of treatment include: Relieving symptoms Improving organ function Controlling inflammation and reducing the size of granulomas (inflamed lumps) Preventing pulmonary fibrosis (lung scarring) if your lungs are affected Your doctor may prescribe topical treatments and/or medicines to treat the disease. Medicines Prednisone Prednisone, a type of steroid, is the main treatment for sarcoidosis. This medicine reduces inflammation. In most people, prednisone relieves symptoms within a couple of months. Although most people need to take prednisone for 12 months or longer, your doctor may lower the dose within a few months after you start the medicine. Long-term use of prednisone, especially at high doses, can cause serious side effects. Work with your doctor to decide whether the benefits of this medicine outweigh the risks. If your doctor prescribes this treatment, he or she will find the lowest dose that controls your disease. When you stop taking prednisone, you should cut back slowly (as your doctor advises). This will help prevent flareups of sarcoidosis. Cutting back slowly also allows your body to adjust to not having the medicine. If a relapse or flareup occurs after you stop taking prednisone, you may need a second round of treatment. If you remain stable for more than 1 year after stopping this treatment, the risk of relapse is low. Other Medicines Other medicines, besides prednisone, also are used to treat sarcoidosis. Examples include: Hydroxychloroquine or chloroquine (known as antimalarial medicines). These medicines work best for treating sarcoidosis that affects the skin or brain. Your doctor also may prescribe an antimalarial if you have a high level of calcium in your blood due to sarcoidosis. Medicines that suppress the immune system, such as methotrexate, azathioprine, or leflunomide. These medicines work best for treating sarcoidosis that affects your lungs, eyes, skin, or joints. Your doctor may prescribe these medicines if your sarcoidosis worsens while you're taking prednisone or if you can't handle prednisone's side effects. If you have Lofgren's syndrome with pain or fever, your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. If you're wheezing and coughing, you may need inhaled medicine to help open your airways. You take inhaled medicine using an inhaler. This device allows the medicine to go straight to your lungs. Anti-tumor necrosis factor drugs, originally developed to treat arthritis, are being studied to treat sarcoidosis. Ongoing Research Researchers continue to look for new and better treatments for sarcoidosis. They're currently studying treatments aimed at the immune system. Researchers also are studying antibiotics as a possible treatment for sarcoidosis that affects the skin. For more information about ongoing research, go to the Clinical Trials section of this article.
Source: NHLBI