Sarcoidosis

...less medical jargon in a 'Quick Glance' format!

Sarcoidosis is an inflammatory disease that starts in your lungs, but in time it can affect virtually any organ in your body, including your liver, skin, heart, nervous system and eyes. Some people have signs and symptoms related to a specific organ, such as shortness of breath from lung problems, but others may have only a vague feeling of illness or no signs or symptoms at all.

Although anyone can develop sarcoidosis, the disease mainly affects adults between the ages of 20 and 40. People of Scandinavian descent and black Americans are particularly at risk. Blacks are also more likely to have severe, chronic symptoms than are whites.

Doctors believe this results from an abnormal immune response. But just what triggers this response isn't known. Doctors do know that sarcoidosis often goes away on its own without treatment — usually within two to three years. Some people may have symptoms for a lifetime, however. And in rare cases it can be fatal.

If you have no signs or symptoms or only minor ones, a wait-and-see approach may be appropriate. Treatment for severe cases is usually with strong anti-inflammatory medications.

Symptoms:
Sometimes it develops gradually and produces signs and symptoms that last for years. Or it may appear suddenly and then disappear just as quickly. In either case, signs and symptoms can vary, depending on which organs are affected and how long you've had the disease.

Sarcoidosis that affects only your lungs, for example, may cause few, if any, symptoms. In fact, you may not know you have the disease until it shows up on a routine chest X-ray. More advanced lung disease may cause shortness of breath (dyspnea) and a cough that won't go away.

A vague feeling of discomfort and fatigue

Fever

Weight loss

Small red bumps on your face, arms or buttocks, a condition more common in blacks than in whites

Red, watery eyes

Arthritis in your ankles, elbows, wrists and hands, commonly associated with bumps in the skin over your shins

Causes:
Doctors don't know the exact cause, although they think it may occur when your immune system overreacts to an unknown toxin, drug or pathogen that enters your body through your airways.

Some experts speculate that the causative agent may be a nontuberculous mycobacterium, a noncontagious member of the family of bacteria that cause tuberculosis. In a small portion of people, sarcoidosis may have a genetic component. Studies are ongoing to investigate the genetic and environmental components of this disease.

Normally, your immune system helps protect your body from foreign substances and invading microorganisms, such as bacteria and viruses. But in sarcoidosis, T-helper lymphocytes — white blood cells that play a key role in your immune response — seem to respond too strongly to a perceived threat. This triggers small areas of inflammation called granulomas.

As the disease progresses, granulomas and scarring may occur in the tissue between the air sacs, stiffening your lungs and reducing the amount of air your lungs can hold.

Treatment:
You may not need treatment if sarcoidosis is affecting only your lungs and nearby lymph nodes. Because it often disappears on its own at this stage, your doctor is likely just to monitor you closely.

When chest X-rays reveal more widespread areas of lung inflammation, your doctor may monitor the disease for three to 12 months and begin treatment only if the inflammation hasn't improved or has progressed.

On the other hand, treatment with medications is usually recommended if your heart, eyes or central nervous system is involved or if your blood-calcium level is elevated.

. . . Powerful anti-inflammatory drugs
Doctors generally use the corticosteroid drug prednisone to treat sarcoidosis. Corticosteroids are powerful anti-inflammatory drugs that mimic the effects of hormones produced by your adrenal glands. They're not the same as the anabolic steroids used by some athletes to increase strength and muscle mass.

Just how long to continue prednisone is a matter of debate. In some cases, you may take medication for several years, in as low a dose as possible while still controlling the disease. For a small percent of people, symptoms return when the medication is discontinued. In addition, prednisone can cause serious side effects, especially when it's taken long-term. These side effects include:

• Osteoporosis, a disease that causes your bones to become thin and brittle, leading to fractures
• High blood pressure
• Cataracts
• Diabetes
• Increased risk of infection
• Weight gain and redistribution of body fat

Talk to your doctor about the best ways to help prevent or reduce the possibility of side effects. One option is to take prednisone every other day, rather than every day.

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...less medical jargon in a 'Quick Glance' format!