From the Guidelines
Sarcoidosis is a systemic disease that can affect multiple organ systems, causing a wide range of symptoms, including fatigue, weight loss, night sweats, fever, respiratory symptoms, skin involvement, ocular symptoms, musculoskeletal symptoms, neurological symptoms, cardiac involvement, gastrointestinal symptoms, and enlarged lymph nodes. The symptoms of sarcoidosis can vary greatly between patients, and some individuals may be asymptomatic 1. According to the European Respiratory Journal, the disease can cause significant morbidity and mortality, with about 5% of patients dying from the disease, primarily due to pulmonary and cardiac involvement 1. The clinical presentation of sarcoidosis exhibits a spectrum of manifestations, ranging from asymptomatic to progressive and relapsing disease, with disease progression often leading to pulmonary impairment or death due to complications of progressive pulmonary fibrosis or cardiac involvement 1.
Common Symptoms
- Fatigue
- Weight loss
- Night sweats
- Fever
- Respiratory symptoms: shortness of breath, dry cough, chest pain, wheezing
- Skin involvement: rashes, nodules, erythema nodosum
- Ocular symptoms: blurred vision, eye pain, light sensitivity
- Musculoskeletal symptoms: joint pain, muscle weakness, bone pain
- Neurological symptoms: headaches, seizures, facial nerve paralysis
- Cardiac involvement: palpitations, irregular heartbeat, fainting
- Gastrointestinal symptoms: abdominal pain, liver dysfunction
- Enlarged lymph nodes, particularly in the chest and neck
Less Common Symptoms
- Sarcoidosis-associated fatigue (SAF)
- Small-fibre neuropathy (SFN)-associated symptoms
- Lupus pernio
- Heerfordt’s syndrome
- L¨ofgren’s syndrome
The diagnosis and treatment of sarcoidosis depend on the presence of symptomatic disease, and the decision to treat an individual patient depends on the risk of death or organ failure and impairment of quality of life (QoL) 1. The management of sarcoidosis should prioritize the prevention of progression to irreversible disease and the improvement of quality of life, with treatment tailored to the individual patient's symptoms and organ involvement.
From the Research
Symptoms of Sarcoidosis
The symptoms of sarcoidosis can vary depending on the organs affected, but common symptoms include:
- Persistent dry cough 2, 3, 4
- Eye and skin manifestations 2, 5
- Weight loss 2
- Fatigue 2
- Night sweats 2
- Erythema nodosum 2, 4
- Dyspnea 3, 4
- Chest discomfort 3
- Lymphadenopathy 3, 4
- Skin lesions 5, 4
- Uveitis 5, 4
- Liver or splenic involvement 5
- Peripheral and abdominal lymphadenopathy 5
- Peripheral arthritis 5
- Cardiac manifestations 5, 6
- Neurological manifestations 5, 6
- Bilateral parotitis 5
- Nasosinusal or laryngeal signs 5
- Hypercalcemia 5
- Renal dysfunction 5
- Myopathy 4
- Polyarthralgia 4
- Posterior uveitis 4
- Splenomegaly 4
- Enlarged parotid and lacrimal glands 4
Organ-Specific Symptoms
Sarcoidosis can affect various organs, leading to specific symptoms, such as:
- Pulmonary symptoms: dry cough, dyspnea, chest discomfort 2, 3
- Ocular symptoms: uveitis, posterior uveitis 5, 4
- Cutaneous symptoms: skin lesions, erythema nodosum 2, 5, 4
- Cardiac symptoms: cardiac manifestations, myopathy 5, 6, 4
- Neurological symptoms: neurological manifestations, polyarthralgia 5, 6, 4
- Renal symptoms: renal dysfunction, hypercalcemia 5, 4