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</div><div><span>Sarcoidosis</span></div></div>
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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Sarcoidosis</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Sarcoidosis is a disease in which inflammation occurs in the lymph nodes, lungs, liver, eyes, skin, and/or other tissues.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>The exact cause of sarcoidosis is unknown. What is known is that when a person has the disease, tiny clumps of abnormal tissue (granulomas) form in certain organs of the body. Granulomas are clusters of immune cells.</p><p>The disease can affect almost any organ. It most commonly affects the lungs.</p><p>Health experts think that having certain genes makes it more likely for a person to develop sarcoidosis. Things that may trigger the disease include infections with bacteria or viruses. Contact with dust or chemicals may also be triggers.</p><p>The disease is more common in African Americans and White people of Scandinavian heritage. More women than men have the disease.</p><p>The disease often begins between ages 20 and 40. Sarcoidosis is rare in young children.</p><p>A person with a close blood relative who has sarcoidosis is nearly 5 times as likely to develop the condition.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>There may be no symptoms. When symptoms do occur, they can involve almost any body part or organ system.</p><p>Almost all people affected by sarcoidosis have lung or chest symptoms:</p><ul><li><a test="test" href="./003079.htm">Chest pain</a> (most often behind the breast bone)</li><li>Dry <a test="test" href="./003072.htm">cough</a></li><li><a test="test" href="./003075.htm">Shortness of breath</a></li><li><a test="test" href="./003073.htm">Coughing up blood</a> (rare, but serious)</li></ul><p>Symptoms of general discomfort may include:</p><ul><li><a test="test" href="./003088.htm">Fatigue</a></li><li><a test="test" href="./003090.htm">Fever</a></li><li><a test="test" href="./003261.htm">Joint ache or pain</a> (arthralgia)</li><li><a test="test" href="./003107.htm">Weight loss</a></li></ul><p>Skin symptoms may include:</p><ul><li><a test="test" href="./003246.htm">Hair loss</a></li><li>Raised, red, firm skin sores (<a test="test" href="./000881.htm">erythema nodosum</a>), almost always on the front part of the lower legs</li><li><a test="test" href="./003220.htm">Rash</a></li><li>Scars that become raised or inflamed</li></ul><p>Nervous system symptoms may include:</p><ul><li><a test="test" href="./003024.htm">Headache</a></li><li><a test="test" href="./003200.htm">Seizures</a></li><li><a test="test" href="./003174.htm">Weakness</a> on one side of the face</li></ul><p>Eye symptoms may include:</p><ul><li><a test="test" href="./003034.htm">Burning, itching, discharge from the eye</a></li><li><a test="test" href="./000426.htm">Dry eyes</a></li><li><a test="test" href="./003032.htm">Pain</a></li><li>Vision loss</li></ul><p>Other symptoms of this disease may include:</p><ul><li><a test="test" href="./007760.htm">Dry mouth</a></li><li><a test="test" href="./003092.htm">Fainting spells</a>, if the heart is involved</li><li><a test="test" href="./003106.htm">Nosebleed</a></li><li>Swelling in the upper part of the abdomen</li><li><a test="test" href="./000205.htm">Liver disease</a></li><li>Swelling of the legs if heart and lungs are involved</li><li>Abnormal heart rhythm if the heart is involved</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>The health care provider will perform a physical examination and ask about the symptoms.</p><p>Different imaging tests may help diagnose sarcoidosis:</p><ul><li><a test="test" href="./003804.htm">Chest x-ray</a> to see if the lungs are involved or lymph nodes are enlarged</li><li><a test="test" href="./003788.htm">CT scan</a> of the chest</li><li><a test="test" href="./003824.htm">Lung gallium scan</a> (rarely done now)</li><li>Imaging tests of the <a test="test" href="./003791.htm">brain</a> and <a test="test" href="./003336.htm">liver</a></li><li>PET scan of the whole body (or specific body parts)</li><li><a test="test" href="./003869.htm">Echocardiogram</a> or <a test="test" href="./003795.htm">MRI</a> of the heart
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</li></ul><p>To diagnose this condition, a biopsy is needed. A <a test="test" href="./003416.htm">biopsy</a> of the lung using <a test="test" href="./003857.htm">bronchoscopy</a> is usually done. Biopsies of other body tissues may also be done.</p><p>The following lab tests may be done:</p><ul><li><div>Calcium levels (<a test="test" href="./003603.htm">urine</a>, <a test="test" href="./003486.htm">ionized</a>, <a test="test" href="./003477.htm">blood</a>)</div></li><li><a test="test" href="./003642.htm">CBC</a></li><li><a test="test" href="./003541.htm">Immunoelectrophoresis</a></li><li><a test="test" href="./003436.htm">Liver function tests</a></li><li><a test="test" href="./003545.htm">Quantitative immunoglobulins</a></li><li><a test="test" href="./003478.htm">Phosphorus</a></li><li><a test="test" href="./003567.htm">Angiotensin converting enzyme (ACE)</a></li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>Sarcoidosis symptoms will often get better without treatment, especially if there are only small lung abnormalities.</p><p>If the eyes, heart, nervous system, or lungs are affected, corticosteroids are usually prescribed. This medicine may need to be taken for 1 to 2 years.</p><p>Medicines that suppress the immune system are sometimes also needed.</p><p>In rare cases, people with very severe heart or lung damage (end-stage disease) may need an organ transplant.</p><p>With sarcoidosis that affects the heart, an implantable cardioverter-defibrillator (<a test="test" href="./007370.htm">ICD</a>) may be needed to treat heart rhythm problems. </p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>Many people with sarcoidosis are not seriously ill, and get better without treatment. Up to half of all people with the disease get better in 3 years without treatment. People whose lungs are affected may develop lung damage.</p><p>Overall the death rate from sarcoidosis is less than 5%. Causes of death include:</p><ul><li><div><div>Bleeding from the lung tissue</div></div></li><li><div><div>Heart damage, leading to heart failure and abnormal heart rhythms</div></div></li><li><div><div>Lung scarring (pulmonary fibrosis)</div></div></li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Sarcoidosis may lead to these health problems:</p><ul><li>Fungal lung infections (<a test="test" href="./001326.htm">aspergillosis</a>)</li><li><a test="test" href="./001620.htm">Glaucoma</a> and blindness from <a test="test" href="./001005.htm">uveitis</a> (rare)</li><li><a test="test" href="./000458.htm">Kidney stones</a> from high calcium levels in blood or urine</li><li><a test="test" href="./000360.htm">Osteoporosis</a> and other complications of taking corticosteroids for long periods of time</li><li>
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High blood pressure in the arteries of the lungs (<a test="test" href="./000112.htm">pulmonary hypertension</a>)</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>Contact your provider promptly if you have:</p><ul><li><div><a test="test" href="./003075.htm">Difficulty breathing</a></div></li><li><div><a test="test" href="./003081.htm">Irregular heartbeat</a></div></li><li><div>Vision changes </div></li><li><div>Other symptoms of this disorder</div></li></ul></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Patient Instructions</h2></div><div class="section-button"><button type="submit" aria-controls="section-carepnt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/1613t.jpg" alt="Sarcoid, stage I - chest X-ray" title="Sarcoid, stage I - chest X-ray" class="side-img"/><a href="../imagepages/1613.htm">Sarcoid, stage I - chest x-ray</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/1614t.jpg" alt="Sarcoid, stage II - chest X-ray" title="Sarcoid, stage II - chest X-ray" class="side-img"/><a href="../imagepages/1614.htm">Sarcoid, stage II - chest x-ray</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/1615t.jpg" alt="Sarcoid, stage IV - chest x-ray" title="Sarcoid, stage IV - chest x-ray" class="side-img"/><a href="../imagepages/1615.htm">Sarcoid, stage IV - chest x-ray</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/2031t.jpg" alt="Sarcoid - close-up of the skin lesions" title="Sarcoid - close-up of the skin lesions" class="side-img"/><a href="../imagepages/2031.htm">Sarcoid - close-up of the skin lesions</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/2532t.jpg" alt="Erythema nodosum associated with sarcoidosis" title="Erythema nodosum associated with sarcoidosis" class="side-img"/><a href="../imagepages/2532.htm">Erythema nodosum associated with sarcoidosis</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/2533t.jpg" alt="Sarcoidosis - close-up" title="Sarcoidosis - close-up" class="side-img"/><a href="../imagepages/2533.htm">Sarcoidosis - close-up</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/2534t.jpg" alt="Sarcoidosis on the elbow" title="Sarcoidosis on the elbow" class="side-img"/><a href="../imagepages/2534.htm">Sarcoidosis on the elbow</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/2535t.jpg" alt="Sarcoidosis on the nose and forehead" title="Sarcoidosis on the nose and forehead" class="side-img"/><a href="../imagepages/2535.htm">Sarcoidosis on the nose and forehead</a></li>
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Iannuzzi MC. Sarcoidosis. Goldman L, Schafer AI, eds. <em>Goldman-Cecil Medicine</em>. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 89.</p><p>Judson MA, Koth LL, Baughman RP. Sarcoidosis. In: Broaddus VC, Ernst JD, King TE, et al, eds. <em>Murray and Nadel's Textbook of Respiratory Medicine</em>. 7th ed. Philadelphia, PA: Elsevier; 2022:chap 93.</p><p>Soto-Gomez N, Peters JI, Nambiar AM. Diagnosis and management of sarcoidosis. <em>Am Fam Physician</em>. 2016;93(10):840-848. PMID: 27175719 <a href="https://pubmed.ncbi.nlm.nih.gov/27175719/" target="_blank">pubmed.ncbi.nlm.nih.gov/27175719/</a>.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 5/3/2023</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<div id="section-version" class="section-body"><p>Updated by: Denis Hadjiliadis, MD, MHS, Paul F. Harron, Jr. Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania,Philadelphia, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.</p>
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