Sarcoidosis, which is also known as sarcoid or Besnier-Boeck disease, is a health condition involving the formation of small nodules known as granulomas at various sites of the body. Sarcoidosis is thought to occur due to inflammatory processes and may have a genetic link, although its exact cause remains unknown.
Sarcoidosis 101 | American Lung Association
The granulomas in sarcoidosis may present in essentially any part of the body but are most commonly found to affect the lungs and lymph glands in the chest area. The symptoms associated with this condition can vary greatly in respect to the location, size, and number of the nodules. Patients with sarcoidosis may or may not require treatments, depending on their specific circumstances.
Epidemiology
The incidence of sarcoidosis is highest among young adults within the age range of 20-29 years old. Additionally, some research has suggested that females are more likely to be affected by sarcoidosis as compared to males. In particular, elderly women over the age of 50 years appear to be at an increased risk of sarcoidosis.
However, anyone can be affected by the condition and individuals from all over the world may have sarcoidosis. It is estimated that 16.5 men and 19 women in every 100,000 people have the condition worldwide.
Sarcoidosis is most prevalent in populations of Northern Europe, such as Sweden and Iceland, which have an estimated annual incidence of 60 per 100,000 people. Although the condition may affect any individual, sarcoidosis is less common in populations in South America and some Asian countries, such as India and the Philippines. However, it is unclear if these findings are due to lower incidence or fewer diagnoses.
Affected areas and symptoms
The granulomas associated with sarcoidosis may appear virtually anywhere in the body and their specific location is indicative of the symptoms that are likely to present.
For example, when the lungs are affected with sarcoidosis nodules, some of the likely symptoms will include dyspnea (shortness of breath), dry cough, wheezing, and chest pain. Comparatively, nodules on the skin will cause a skin rash, red bumps, and patches to arise.
Sarcoidosis nodules within the cardiovascular system, particularly those present in or around the heart, will likely lead to symptoms such as bradycardia and arrhythmias. Nodules that are on or around the nerves will typically cause symptoms such as dysphagia, drooping face, abnormalities of senses, numbness, and prickling sensations. When the eyes are affected by sarcoidosis, symptoms of uveitis, redness, dryness, and abnormal vision may be present.
Diagnosis
The diagnosis of sarcoidosis can be difficult, as the presenting symptoms can vary greatly and each case may present differently. A full medical history should be taken, including any family history of sarcoidosis and recent environment or occupational factors that may have triggered the onset of the disease.
A physical examination is then required of any nodules that are easily visible. Other factors that will be studied during the physical exam include the heartbeat, shortness of breath, red eyes, and enlarged internal organs.
If sarcoidosis is suspected, further tests can then be requested. These may include a chest X-ray if there is involvement of the chest, as well as other imaging techniques for other areas of the body. Blood tests may also be useful to monitor the patient's general health.
Finally, a biopsy of the affected tissue can be taken and tested for the presence of sarcoidosis. This is the best way to confirm the diagnosis when suspected through other testing means.
Treatment
Many people with sarcoidosis do not require treatment, as symptoms often improve spontaneously over time. However, some individuals may benefit from medication to assist in pain management such as non-steroidal anti-inflammatory drugs (NSAIDs).
For more severe cases, corticosteroid medication is the treatment of choice. This helps to reduce the inflammation that is responsible for nodule formation and is often effective in improving symptoms. When corticosteroids are not successful, immunosuppressant medication may offer a benefit; however, these drugs should be used with caution due to the high risk of severe side effects.
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