Sarcoidosis, also known as sarcoid or Besnier-Boeck disease, is a health condition involving the formation of small nodules known as granulomas at various sites of the body. It is thought to occur due to inflammatory processes and may have a genetic link, although the exact cause in unknown.
The granulomas may present in essentially any part of the body, but are most commonly found to affect the lungs and lymph glands in the chest area. The symptoms experienced vary greatly in respect to the location, size and number of the nodules and may or may not require treatments, depending on the specific circumstances of the patient.
The incidence of sarcoidosis is highest among young adults in the 20-29 year old age group, with some research suggesting the females are more likely to be affected. Additionally, elderly women over the age of 50 years are also at an increased risk of sarcoidosis.
However, anyone can be affected by the condition and individuals from all over the world may have sarcoidosis. It is estimated that 16.5 men and 19 women in every 100,000 people have the condition worldwide.
It is most prevalent in populations of Northern Europe, such as Sweden and Iceland, which has peaked at an annual incidence of 60 per 100,000 people. Although may affect any individual, it is less common in populations in South America and some Asian countries, such as India and the Philippines. However, it is unclear if these findings are due to lower incidence or few diagnoses.
Affected Areas and Symptoms
The granulomas associated with sarcoidosis may appear virtually anywhere in the body and their specific location is indicative of the symptoms that are likely to present. They may affect the:
- Lungs – with likely symptoms of dyspnea (shortness of breath), dry cough, wheezing and chest pain
- Skin – with likely symptoms of skin rash, red bumps and patches
- Heart – with likely symptoms of brachycardia and arrhythmia
- Nerves – with likely symptoms of dysphagia, drooping face, abnormalities of senses, numbness, prickling sensation
- Eyes – with symptoms of uveitis, redness, dryness and abnormal vision
The diagnosis of sarcoidosis can be difficult as the presenting symptoms can vary greatly and each case may present differently. A full medical history should be taken, including any family history of sarcoidosis and recent environment or occupational factors that may have triggered the onset of the disease.
A physical examination is then required of any nodules if easily visible and to observe other factors, such as heartbeat, shortness of breath, red eyes, and enlarged internal organs.
If sarcoidosis is suspected, further tests can then be requested. These may include a chest X-ray if there is involvement of the chest, as well as other imaging techniques for other areas of the body. Blood tests may also be useful to monitor general health.
Finally, a biopsy of the affected tissue can be taken and tested for the presence of sarcoidosis. This is the best way to confirm the diagnosis when suspected through other testing means.
Many people with sarcoidosis do not require treatment as the symptoms often improve spontaneously over time. However, some individuals pay benefit from medication to assist in pain management such as non-steroidal anti-inflammatory drugs (NSAIDs).
For more severe cases, corticosteroid medication is the treatment of choice. This helps to reduce the inflammation that is responsible for the nodule formation and in often effective in help to improve symptoms. When corticosteroids are not successful, immunosuppressant medication may offer a benefit but should be used with caution due to the high risk of severe side effects.