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sarcoidosis An inflammatory disorder in which
multiple granulomas (nodules of hardened LY M P H
and fibrous tissues) form in organs and tissues
throughout the body. Sarcoidosis most commonly
affects the LUNGS, LIVER, lymph nodes, eyes, and
SKIN, though can affect any body structure. The
granulomas typically have alternating growth and
REMISSIONstages, though generally cause perma-
nent scarring. Though most people who have sar-
coidosis develop small granulomas and have mild
symptoms, sarcoidosis can be severe when the
granulomas clump together to form large enough
lesions to interfere with an organ’s functions. Sar-
coidosis that affects the HEART can cause life-
threatening ARRHYTHMIAwith high risk for SUDDEN
CARDIAC DEATH.

Symptoms and Diagnostic Path

Most often sarcoidosis begins in the lungs, causing
pulmonary symptoms, and in the lymph nodes.
Symptoms are specific for the organ system
involved. Generalized symptoms may include

• fatigue, weakness, and malaise (general sense
  of not feeling well)


• weight loss and loss of APPETITE


• FEVER


• night sweats and sleep disturbances


• SPLENOMEGALY(enlarged SPLEEN)


• HEPATOMEGALY(enlarged liver)


• enlarged, tender lymph nodes


• HEADACHE


• ERYTHEMA NODOSUM (red, painful skin lesions
  most commonly appearing on the shins)

The diagnostic path begins with BLOODtests,
chest X-RAY, and pulmonary function tests (95

percent of people who have sarcoidosis have lung

involvement). The doctor may conduct other diag-

nostic procedures, depending on the symptoms

and the necessity to rule out other causes for

them. Though various procedures can show char-

acteristic evidence of sarcoidosis, there are no con-

clusive diagnostic tests for sarcoidosis. Imaging

procedures such as COMPUTED TOMOGRAPHY (CT)

SCANandMAGNETIC RESONANCE IMAGING(MRI) can

reveal the extent of damage present as a conse-

quence of the granulomas.

Treatment Options and Outlook

Long-term treatment (up to a year) with CORTICO-

STEROID MEDICATIONSreduces the INFLAMMATIONthat

causes symptoms and mitigates the consequential

damage. Topical medications can improve skin

symptoms. Severe or resistant symptoms may

require IMMUNOSUPPRESSIVE THERAPYorIMMUNOTHER-

APY. Even with treatment, sarcoidosis remains a

chronic condition with alternating periods of

remission (no symptoms) and exacerbation

(resumed or intensified symptoms).

MEDICATIONS TO TREAT SARCOIDOSIS

azathioprine cyclophosphamide

etanercept hydroxychloroquine

infliximab methotrexate

pentoxifylline prednisone

tetracycline thalidomide

Risk Factors and Preventive Measures

There are no clear risk factors for sarcoidosis,

though it is more common and often more severe

in African American women. Nor are there any

known measures to prevent sarcoidosis from

developing. Researchers believe many people have

undetected sarcoidosis, making this inflammatory

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