From the Guidelines
Sarcoidosis is a systemic inflammatory disease characterized by the formation of granulomas in multiple organs, with symptoms varying widely depending on the organs involved, and can range from asymptomatic to progressive and relapsing disease, with potential complications including pulmonary impairment, cardiac involvement, and death 1. The clinical presentation of sarcoidosis can include a spectrum of manifestations, such as:
- Fatigue, fever, night sweats, weight loss, and general malaise
- Pulmonary symptoms, including persistent dry cough, shortness of breath, and chest pain
- Skin manifestations, including erythema nodosum, rashes, and lupus pernio
- Ocular symptoms, including eye pain, blurred vision, and light sensitivity
- Musculoskeletal involvement, causing joint pain, swelling, and muscle weakness
- Cardiac sarcoidosis, which may present with palpitations, chest pain, or heart failure, and is estimated to affect 20% to 50% of patients with sarcoidosis, with a significant risk of mortality 1
- Neurological symptoms, ranging from headaches to seizures or facial nerve paralysis
- Kidney involvement, leading to kidney stones or impaired function
- Liver and spleen enlargement, sometimes with abdominal pain
- Salivary and lacrimal gland inflammation, causing dry mouth and eyes The diagnosis and management of sarcoidosis require a comprehensive approach, including clinical evaluation, imaging, and often biopsy to confirm granuloma presence while excluding other conditions, and treatment may involve immunosuppressive therapy, such as corticosteroids, methotrexate, or TNF inhibitors, to prevent complications and improve quality of life 1.
From the Research
Systemic Symptoms of Sarcoidosis
- Sarcoidosis is a systemic inflammatory disease that can affect various organs, including the lungs, skin, and joints 2.
- The disease can present with symptoms related to the involvement of these organs, as well as other systems 3.
- Extrapulmonary manifestations are common and diverse, and can affect practically any organ system 2.
Organ-Specific Symptoms
- Pulmonary symptoms: almost all patients present with pulmonary or mediastinal lymph node disease 2.
- Skin symptoms: skin involvement is common, but the specific symptoms are not well-defined in the provided studies.
- Joint symptoms: joint involvement can occur, but the specific symptoms are not well-defined in the provided studies.
Treatment-Related Symptoms
- Corticosteroids are the basis of treatment for symptomatic sarcoidosis, but can have toxicities 3, 4.
- Alternative medications, such as methotrexate and azathioprine, may be considered to minimize corticosteroid dose and toxicity 3, 5, 6.
- Immunosuppressives and biologics may be used as second-line or third-line therapy, depending on the patient's response to treatment 5, 6.