What Is Sarcoidosis?

By: PETER HUTCH

Sarcoidosis, also called sarcoid (from the Greek ‘sark’ and ‘oid’ meaning “flesh-like”) or Besnier-Boeck disease, is an immune system disorder characterised by non-caseating granulomas (small inflammatory nodules) that most commonly arises in young adults. The cause of the disease is still unknown. Virtually any organ can be affected; however, granulomas most often appear in the lungs or the lymph nodes. Symptoms can occasionally appear suddenly but usually appear gradually. The clinical course varies and ranges from asymptomatic disease to a debilitating chronic condition that may lead to death. Sarcoidosis was once thought to be an uncommon condition. It’s now known to affect tens of thousands of people throughout the United States. Because many people who have sarcoidosis have no symptoms, it’s hard to know how many people have the condition.

Sarcoidosis is characterized by noncaseating epithelioid granulomas that may affect any organ system. Although Jonathan Hutchinson described the first case in 1869, the etiology of the disease is still unknown. The disease most commonly involves granuloma formation in the lungs. Other commonly involved organ systems include the lymph nodes (especially the intrathoracic nodes); the skin; the eyes; the liver; the heart; and the nervous, musculoskeletal, renal, and endocrine systems.

Sarcoidosis is a disease that results from a specific type of inflammation of tissues of the body. It can appear in almost any body organ, but it starts most often in the lungs or lymph nodes. Sarcoidosis was first identified over 100 years ago by two dermatologists working independently, Dr. Jonathan Hutchinson in England and Dr. Caesar Boeck in Norway.

Doctors believe sarcoidosis 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 sarcoidosis can be fatal. Sarcoidosis may be mild, or it can be severe and do lasting damage. It does not always cause symptoms, so you can have it without knowing it. Symptoms vary, depending on which organs are affected. No one is sure what causes sarcoidosis. It affects men and women of all ages and races worldwide. However, it occurs mostly in people ages 20 to 40, African Americans, especially women, and people of Asian, German, Irish, Puerto Rican and Scandinavian origin. Sometimes sarcoidosis 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. The cause of the disease is unknown. Sarcoidosis is marked by abnormal inflammatory masses (granulomas) in certain organs of the body. Granulomas are clusters of immune cells (macrophages, lymphocytes, and multinucleated giant cells). The disease can affect almost any organ of the body, although it most commonly affects the lungs. Sarcoidosis can be acute, subacute, or chronic. Common symptoms of sarcoidosis in the eyes include: burning, itching and/or pain, dryness, tearing, red eyes, vision problems such as seeing black spots (called floaters) and blurred vision, sensitivity to light and small, pale yellow bumps on the eye. A condition called uveitis, which is inflammation of the membranes (uvea) of the eye, can result in many of these symptoms. Rarely, glaucoma, cataracts and blindness can occur if uveitis goes untreated. As a precaution, a routine eye examination performed by an ophthalmologist is recommended for anyone with suspected sarcoidosis. It is a good idea to schedule them annually for several years after your diagnosis, and routinely as recommended thereafter.

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