Which organ is most commonly involved in sarcoidosis?

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Last updated: April 25, 2025View editorial policy

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From the Guidelines

The lungs are the most common organ involved in sarcoidosis, affecting approximately 90% of patients with this condition. Sarcoidosis is a multisystem inflammatory disorder characterized by the formation of granulomas (collections of inflammatory cells) in various organs. While sarcoidosis can affect virtually any organ system in the body, including the skin, eyes, liver, heart, and nervous system, the lungs are overwhelmingly the most frequently affected site, as noted in the European Respiratory Journal study 1. The disease typically manifests in the lungs as hilar lymphadenopathy (enlarged lymph nodes in the chest) and pulmonary infiltrates visible on chest imaging.

Some key points to consider about sarcoidosis include:

  • The clinical presentation of sarcoidosis exhibits a spectrum of manifestations ranging from the asymptomatic state to that of progressive and relapsing disease, as discussed in the American Journal of Respiratory and Critical Care Medicine study 1.
  • Disease progression often leads to pulmonary impairment or, in some cases, death due to complications of progressive pulmonary fibrosis or from cardiac involvement.
  • The global health implications of sarcoidosis remain unknown, but new evidence indicates that the disease is much more prevalent than previously estimated.
  • Mortality among patients with sarcoidosis is much higher than previously reported in some patient populations, highlighting the importance of early diagnosis and treatment.

The predilection for lung involvement is thought to be related to the respiratory system's constant exposure to environmental antigens that may trigger the abnormal immune response characteristic of sarcoidosis in genetically susceptible individuals, as suggested by the study in the European Respiratory Journal 1. Patients with pulmonary sarcoidosis may experience symptoms such as cough, shortness of breath, and chest pain, though many patients remain asymptomatic despite having radiographic evidence of the disease.

From the Research

Organ Involvement in Sarcoidosis

  • The lung is the organ most commonly involved with sarcoidosis, with at least 90% of sarcoidosis patients demonstrating lung involvement in most series 2, 3, 4, 5.
  • Other commonly involved organs include:
    • Skin
    • Eye
    • Liver
    • Peripheral lymph node with the frequency of involvement ranging from 10 to 30% 2.
  • Cardiac sarcoidosis is present in 25% of all sarcoidosis patients, but only causes clinical problems in 5% of them 2.
  • The actual frequency of sarcoidosis organ involvement is probably much higher as it is frequently asymptomatic and may avoid detection, particularly with lung, liver, cardiac, and bone involvement 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

The Clinical Features of Sarcoidosis: A Comprehensive Review.

Clinical reviews in allergy & immunology, 2015

Research

Pulmonary sarcoidosis: typical and atypical manifestations at high-resolution CT with pathologic correlation.

Radiographics : a review publication of the Radiological Society of North America, Inc, 2010

Research

Pulmonary manifestations of sarcoidosis.

Presse medicale (Paris, France : 1983), 2012

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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