The sarcoidosis is a rare inflammatory disease. Sufferers develop small subcutaneous nodules made up of granular tissue. It occurs due to a regulatory failure of the immune system and affects vital organs such as the lungs, heart and brain.
In the case of Spain, the prevalence is 1.36 cases per 100,000 inhabitants. However, they are barely diagnosed in 10% of cases since this disease is sometimes asymptomatic.
What is sarcoidosis?
Sarcoidosis is known as a disease characterized by the abnormal and progressive growth of a set of inflammatory cells , which are called granulomas, in different areas of the body: lungs, lymph nodes, eyes and skin.
Despite the numerous studies that have been carried out to determine what causes sarcoidosis, experts still do not know for sure. There are some theories that indicate that people suffer from this disorder due to an unknown substance present in the air.
To this day there is no cure for this disease. In a high percentage of cases, the medium and long-term prognosis is positive with simple treatment. However, certain patients suffer from this disease for several years, thus damaging some organs.
- Heerfordt-Waldenstrom syndrome : it is one of the most complex types of the disease. Patients have the following symptoms: fever , parotid enlargement, eye inflammation, and even facial paralysis in the most severe cases.
- Löfgren’s syndrome : it is known as such to the symptoms that certain patients who suffer from sarcoidosis present. The most common are high fever, swollen lymph nodes, and arthritis in the ankles.
- Sarcoidosis type Darier-Roussy : in this case a series of nodules form under the skin. They are usually located on the trunk and extremities.
- Mikuliczs syndrome : the most common signs are fever, an enlarged submandibular area, and facial paralysis.
The lungs are the organs most affected by this disease. Sarcoidosis causes lung inflammation, which, if not treated properly, forms scars or cysts. The most noticeable symptoms are shortness of breath and chest pain. In the most severe cases the right side of the heart can become overloaded, thus causing heart failure.
Sarcoidosis also frequently affects the skin . It usually begins almost imperceptibly, with the growth of granulomas on the ankles. Gradually, the subcutaneous nodules begin to affect other areas of the body and other symptoms appear, such as fever.
In 25% of cases the eyes are affected. This disease causes redness, inflammation and pain in the eyes, which greatly affects vision. If the inflammation persists over time, it can obstruct the tear duct, causing glaucoma . In certain cases, granulomas form on the membrane that covers the eyeball, as well as on the inside of the eyelids.
One of the most serious types of sarcoidosis of all. When granulomas form in the heart , patients can suffer from chest pain and heart failure.
Causes of sarcoidosis
Experts do not know what the exact cause of this disease is. Some studies have revealed that certain patients have a genetic predisposition to develop it. Meanwhile, there are others who argue that the cause is found in a bacteria or virus present in the air and that it enters the body through inhalation.
Still, there are a number of risk factors that increase a person’s chances of suffering from this disorder.
- Age: Almost 100% of sarcoidosis patients are between 20 and 40 years of age.
- Gender: although there are no significant differences between the two genders, women are slightly more likely to develop this disease.
- Race: in terms of race, it is African Americans who have the highest incidence. In addition, they are the ones who suffer the most lung problems from this disorder.
- Genetics: and finally, genetics play a very important role. Those who have someone in the family who has had the disease, the chances of suffering it are multiplied.
As for the symptoms of sarcoidosis, they vary depending on which organs are affected , as well as the level of damage that the disease has caused in them.
This is a disorder that varies remarkably from one patient to another. In some, the signs appear suddenly and disappear in record time, sometimes without any medical treatment . Meanwhile, in others the signs manifest gradually and last for several years. There are even cases of sarcoidosis patients who do not have any symptoms, so they discover that they have the disease when they have a chest X-ray for any other reason.
General signs are: fatigue, extreme tiredness, swollen lymph nodes, and weight loss for no apparent reason.
Depending on the area of the body affected by the granulomas, the specific symptoms are different.
- Lungs: One of the most common types of sarcoidosis is the one that affects the lungs. The most common recurring signs are a dry cough , shortness of breath, and severe chest pain.
- Skin: it is precisely the signs that appear on the skin that are the most noticeable of all. These include: red or purple bumps that form on the ankles, sores on the face, and nodules around scars.
- Eyes: The eyes can also be affected by this disorder. In this case the symptoms are: blurred vision, severe pain in the eyes and sensitivity to light.
- Heart: and finally, this disease can also affect the heart. It is what is known as cardiac sarcoidosis. The symptoms suffered by the vast majority of patients are arrhythmia fatigue, shortness of breath and chest pain.
Once some of the symptoms described in the previous section have been presented, it is important to see a doctor as soon as possible. If you suspect sarcoidosis, you will most often request the following tests.
- Blood test: the blood test allows to assess the status of the different components, such as platelets or red blood cells. Thus, the doctor can check how the different organs that make up the human body are working.
- Biopsy: If the patient has subcutaneous nodules, the doctor can remove tissue from them for later analysis in the laboratory.
- Chest X-ray: in 90% of cases there are alterations in the chest X-ray. It is therefore one of the most reliable diagnostic tests to determine if a patient suffers from sarcoidosis.
- Spirometry: as for spirometry, it is used to check if there is any obstruction in the airways due to inflammation in the lungs.
- Electrocardiogram: it is requested when there is suspicion that sarcoidosis is affecting the heart. It allows to determine if there is arrhythmia or any other problem.
It is important to make a proper diagnosis. And there are other diseases that are also characterized by the formation of granulomas in certain areas of the body, such as pneumoconiosis.
The treatment for this disease varies remarkably from one patient to another. In some cases, they do not even need any treatment since the disorder remains stable over time.
However, when the symptoms are of some severity or may cause health complications, it is necessary for patients to take corticosteroids, which are anti-inflammatory.
When sarcoidosis leads to complications in the lungs, treatment with inhaled corticosteroids is necessary.
Sarcoidosis and pregnancy
In general, this disease does not adversely affect pregnancy. However, if a pregnant woman suffers from sarcoidosis, it is essential that she undergo continuous monitoring, both during pregnancy and in the following months.
Regarding whether sarcoidosis is hereditary, the most accepted theory at present is that although genetic factors influence the development of the disorder, by themselves they are not sufficient for it.
As we have pointed out, in a high percentage of cases this disease disappears by itself, without causing any type of health complication. However, there are some cases in which problems do occur in the long term.
The lungs are the most affected organs. Left untreated pulmonary sarcoidosis can cause a series of scars to form in the lungs. These scars, depending on their size and location, can cause breathing difficulties.
As for the eyes, permanent vision loss can occur if the inflammation is severe. Although it is not very common, this disorder can cause the development of ocular cararats.
Other organs that can be affected are the kidneys. Some patients suffer kidney failure over time.
One of the most serious complications occurs in the heart. When granulomas form in the heart muscle, arrhythmias and other problems can occur , which can even lead to death.
One of the main concerns of those who suffer from this disease has to do with the prognosis both in the short and long term. The truth is that it is very favorable in the vast majority of cases. Many patients heal spontaneously, without the need for any treatment. The vast majority of sarcoidosis cases also have a favorable course with proper treatment.
Only 5% of patients die from this disorder. Death occurs when granulomas have affected vital organs such as the brain, heart, and lungs.
Evolution of the disease
The course of sarcoidosis varies greatly from patient to patient.
- In many cases the disorder is mild . The inflammation that produces the formation of granulomas improves without the need for treatment. Thus, they stop growing on their own and the symptoms disappear after a while.
- In other cases the inflammation remains , but without worsening or causing any complications. In these cases, patients may relapse from time to time, so it is necessary to reactivate the treatment.
- In the rarest cases, sarcoidosis progressively worsens, and can cause permanent damage to different organs. Although treatment is helpful, sarcoidosis can cause scarring that affects how well the scars work.
How can it be prevented?
There is no method to prevent this disorder as the exact cause of it is unknown. However, those with a family history of sarcoidosis are more likely to develop it. In the case of monozygotic twins , the probability can reach 50%.
How to live with sarcoidosis?
To maintain good health over time, there are a number of guidelines that are recommended to follow.
Taking into account that this disease affects the lungs in the vast majority of cases , it is recommended not to smoke. In addition, it is advisable to avoid any type of substance that can damage these organs, such as dust or chemical elements.
Of course, it is essential to follow a healthy and balanced diet, with a high consumption of fruits and vegetables. Regular moderate physical exercise can also be of great help in maintaining good health.
And, finally, note that there are support groups for patients with sarcoidosis. They can be of great help to know other experiences and learn to live with this disease.
Hello Readers, I am Nikki Bella a Psychology student. I have always been concerned about human behavior and the mental processes that lead us to act and think the way we do. My collaboration as an editor in the psychology area of Well Being Pole has allowed me to investigate further and expand my knowledge in the field of mental health; I have also acquired great knowledge about physical health and well-being, two fundamental bases that are directly related and are part of all mental health.