Sarcoidosis is an immune system condition in which chronic inflammation leads to the formation of small clumps of immune cells — granulomas — in various tissues and organs.
The disease can affect any region of the body, but shows up more commonly in the lungs and lymph nodes, with symptoms such as shortness of breath and chronic coughing. However, other organs, such as the eyes, skin, and liver, also can be affected, leading to a range of symptoms.
Some people experience sudden and rapidly escalating symptoms that disappear in a short time. Others have symptoms that develop gradually and last longer. In some cases, there are no symptoms, with the disease being seen in a chest X-ray.
Lung symptoms
About 90% of people with sarcoidosis have lung symptoms, such as shortness of breath and a persistent cough. Patients also may have wheezing and chest pain, but these symptoms are less common.
The presence of granulomas in the lungs also can cause swollen lymph nodes in the chest, narrowing of the airways, and scarring (fibrosis) of the tissues. Scarring affects the alveoli, the tiny air sacs in the lungs, making it difficult to breathe.
Skin symptoms
Skin problems occur in 20—30% of people with sarcoidosis. The symptoms include abundant sweating, tender and painful red bumps that are usually accompanied by joint pain, and rashes on the upper body.
Patients also may experience plaques (raised areas on the skin), patches of skin with different color, and hair loss in advanced stages of the disease.
Eye symptoms
The eyes and surrounding tissues also are frequently affected in sarcoidosis patients. Inflammation can affect any part of the eye, but the most common problem is inflammation of the iris (the pigmented part of the eye) and surrounding tissue, leading to symptoms such as light sensitivity, blurred vision, and tearing.
Sarcoidosis patients may feel pain, burning, itching, and redness in the eyes.
Patients with long-term disease frequently have dry eyes, and other conditions are likely to develop, such as glaucoma (a condition that damages the optic nerve), cataracts, and blindness.
Heart problems
Cardiac issues are present in up to 28% of patients with sarcoidosis, but only about 5% of patients experience symptoms.
The most frequent symptoms include chest pain and an enlargement of the heart’s right ventricle, which often leads pulmonary hypertension. A condition that affects the heart muscle known as cardiomyopathy also may occur.
Defects in the heart’s electrical activity may occur, which can result in heart block — when the heart beats slower than normal — and arrhythmia (irregular heartbeats). These conditions often lead to palpitations or dizzy spells.
Fainting also may occur due to granulomas in the heart.
Nervous system symptoms
In about 5—15% of sarcoidosis patients, the granulomas develop in the nervous system (the brain, spinal cord) or peripheral nerves located outside the brain and spinal cord.
Patients may experience ataxia, a condition that diminishes muscle control or coordination, and seizures. Other symptoms include headaches, fever, cognitive problems, gastrointestinal difficulties, pain and numbness in the face, arms and legs, and flushing.
Other symptoms
Patients with sarcoidosis often experience symptoms such as fatigue and weight loss before other, more specific symptoms are evident.
Bone and muscle symptoms, changes in bone structure, or muscle pain, are experienced by 10—15% of patients. Swelling and pain in joints also may occur.
Less common symptoms include cirrhosis (scarring of the liver) as a result of granulomas in the liver, and kidney stones because of disrupted calcium management.
Last updated: July 22, 2021
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