The symptoms of sarcoidosis vary significantly between patients due to the size, number and location of the nodules that characterize the health condition. There may be one area of the body that is most affected – usually the lungs and chest area – or several body organs that may lead to specific symptoms.
Some people with the condition do not experience troublesome symptoms, and the diagnosis is made on X-ray findings alone. For other patients, the symptoms may be debilitating and require ongoing management for normal daily activities.
Often symptoms develop over a short period of time and improve spontaneously without treatment, known as acute sarcoidosis. Some patients find that symptoms gradually worsen over time to become more severe, known as chronic sarcoidosis.
There are some symptoms that affect many patients that are considered general, as they are not linked to the formation of nodules in a particular area of the body. These include:
- Loss of appetite
- Weight loss
More commonly, specific symptoms develop due to the formation of nodules in specific areas of the body.
The lungs are one of the most common areas of the body to lead to symptoms, affecting approximately 9 of 10 people with sarcoidosis. This may present as:
- Dyspnea (shortness of breath)
- Persistent dry cough
- Chest pain
Approximately 25% of patients experience skin changes due to granulomas in or near the skin. This may include:
- Erythema nodosum: particularly common rash on shins
- Lupus pernio - rash on nose, cheeks, chin or ears
- Tender red bumps or patches on skin
The heart can be affected by nodules forming directly in the heart tissue, or due to changes that arise from nodules in the neighboring lungs. Cardiac symptoms may include:
- Enlarged right side of heart (due to lung changes)
Changes to the heart and cardiomyopathy can lead to potentially fatal outcomes such as heart failure and should, therefore, be established as soon as possible for appropriate management.
Symptoms that may arise as a result of nodules forming in or near nerves may include:
- Drooping of face
- Vision problems
- Hearing problems
- Prickling sensation
Patients with nodules close to their eyes may experience related symptoms such as:
- Red eyes
- Painful eyes
- Dry eyes
- Blurred vision
It is important for patients with sarcoidosis that notice changes in their eyesight to seek medical attention immediately to reduce the risk of lasting damage.
Other Specific Symptoms
According to the location of the granulomas, there are several other specific organs or areas of the body that may be affected. These include:
- Lymph glands – swollen lumps under the arms, in the neck or in the groins, which are usually evident on with X-ray imaging.
- Kidneys – increased concentration of calcium in the blood may lead to the formation of kidney stones.
- Liver and spleen– enlargement can result in abnormal blood clotting factors and anaemia.
- Bones – can be affected by cysts and cause significant pain
- Muscles – can become inflamed
- Joints – lead to chronic pain in the area