What symptoms occur during a sarcoidosis flare?

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From the Guidelines

During a sarcoidosis flare, patients typically experience a worsening of symptoms that may include persistent dry cough, shortness of breath, chest pain, fatigue, and fever. These symptoms can vary widely depending on which organs are affected, with pulmonary involvement being most common 1. Some patients may also experience joint pain and swelling, skin rashes (particularly erythema nodosum), eye inflammation, and enlarged lymph nodes 1. Additionally, some patients report unexplained weight loss, night sweats, and muscle weakness, while others may experience neurological symptoms like headaches, facial paralysis, or seizures if the nervous system is affected 1. Cardiac sarcoidosis may cause palpitations or irregular heartbeats, and these flares occur because of increased inflammatory activity, with granulomas (collections of inflammatory cells) forming in affected tissues and disrupting normal organ function 1. Key symptoms to look out for during a flare include:

  • Persistent dry cough
  • Shortness of breath
  • Chest pain
  • Fatigue
  • Fever
  • Joint pain and swelling
  • Skin rashes
  • Eye inflammation
  • Enlarged lymph nodes
  • Unexplained weight loss
  • Night sweats
  • Muscle weakness
  • Neurological symptoms like headaches, facial paralysis, or seizures
  • Palpitations or irregular heartbeats due to cardiac sarcoidosis. Patients experiencing a flare should contact their healthcare provider promptly, as treatment adjustments may be needed, typically involving corticosteroids like prednisone to reduce inflammation, and monitoring organ function through regular testing is essential during flares to prevent long-term damage 1.

From the Research

Sarcoidosis Flare Symptoms

The symptoms that occur during a sarcoidosis flare can vary depending on the organs involved. Some common symptoms include:

  • Fatigue
  • Fever
  • Weight loss
  • Eye pain
  • Dyspnea (shortness of breath)
  • Chest pain 2

Organ-Specific Symptoms

Sarcoidosis can affect various organs, leading to a range of symptoms, such as:

  • Joint symptoms (e.g., arthritis)
  • Skin symptoms (e.g., rashes)
  • Lung symptoms (e.g., coughing, wheezing)
  • Eye symptoms (e.g., uveitis, conjunctivitis) 3, 2

Treatment-Related Symptoms

In some cases, symptoms may be related to treatment, rather than the disease itself. For example:

  • Corticosteroid side effects (e.g., weight gain, mood changes)
  • Immunosuppressant side effects (e.g., increased risk of infections) 4, 5, 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Use of methotrexate in patients with sarcoidosis.

Clinical and experimental rheumatology, 2010

Research

Corticosteroids in Sarcoidosis.

Rheumatic diseases clinics of North America, 2016

Research

Treatment of sarcoidosis: grading the evidence.

Expert review of clinical pharmacology, 2018

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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