Sarcoidosis is an inflammatory disease that affects one or more organs but most commonly affects the lungs and lymph glands.But it can also affect the eyes, skin, heart and other organs. As a result of the inflammation, abnormal lumps or nodules (called granulomas) form in one or more organs of the body. These granulomas may change the normal structure and possibly the function of the affected organ(s).
Staging helps doctors understand how advanced the condition is. It can also help them understand which treatments might be right for you.
A stage is assigned after a chest X-ray. This imaging test reveals several important factors about how the condition is affecting your lungs.
• Stage 1.
Lymph nodes near the heart and lungs are enlarged, but there is no fluid or substances in the lungs. Granulomas may be found if a lung tissue biopsy is taken.
• Stage 2.
Enlarged lymph nodes near the heart and lungs are present, and infiltrates (blood, pus, or proteins) are found in the lungs as well.
• Stage 3.
Infiltrates are present in the lungs, but the lymph nodes are not enlarged or swollen.
• Stage 4.
Lungs show obvious signs of pulmonary fibrosis. Damaged or scarred lung tissue prevents the lungs from working properly and filling up fully with air.
Signs and symptoms of sarcoidosis vary depending on which organs are affected. Sarcoidosis sometimes develops gradually and produces symptoms that last for years. Other times, symptoms appear suddenly and then disappear just as quickly. Many people with sarcoidosis have no symptoms, so the disease may be discovered only when a chest X-ray is done for another reason.
▪︎ General symptoms
Sarcoidosis can begin with these signs and symptoms:
• Swollen lymph nodes
• Weight loss
• Pain and swelling in joints, such as the ankles
▪︎ Lung symptoms
Sarcoidosis most often affects the lungs and may cause lung problems, such as:
• Persistent dry cough
• Shortness of breath
• Chest pain
▪︎ Skin symptoms
Sarcoidosis may cause skin problems, which may include:
• A rash of red or reddish-purple bumps, usually located on the shins or ankles, which may be warm and tender to the touch
• Disfiguring sores (lesions) on the nose, cheeks and ears
• Areas of skin that are darker or lighter in color
• Growths under the skin (nodules), particularly around scars or tattoos
▪︎ Eye symptoms
Sarcoidosis can affect the eyes without causing any symptoms, so it’s important to have your eyes checked regularly. When eye signs and symptoms do occur, they may include:
• Blurred vision
• Eye pain
• Burning, itching or dry eyes
• Severe redness
• Sensitivity to light
▪︎ Heart symptoms
Signs and symptoms related to cardiac sarcoidosis may include:
• Chest pain
• Shortness of breath (dyspnea)
• Fainting (syncope)
• Irregular heartbeats (arrhythmias)
• Rapid or fluttering heart beat (palpitations)
• Swelling caused by excess fluid (edema)
Sarcoidosis can also affect calcium metabolism, the nervous system, the liver and spleen, muscles, bones and joints, the kidneys, lymph nodes, or any other organ
The exact cause of sarcoidosis is not known. It may be a type of autoimmune disease associated with an abnormal immune response, but what triggers this response is uncertain. How sarcoidosis spreads from one part of the body to another is still being studied.
Risk Factors –
While anyone can develop sarcoidosis, factors that may increase your risk include:
• Age and sex.
Sarcoidosis can occur at any age, but often occurs between the ages of 20 and 60 years. Women are slightly more likely to develop the disease.
People of African descent and those of Northern European descent have a higher incidence of sarcoidosis. African-Americans are more likely to have involvement of other organs along with the lungs.
• Family history.
If someone in your family has had sarcoidosis, you’re more likely to develop the disease.
Sometimes sarcoidosis causes long-term problems.
Untreated pulmonary sarcoidosis can lead to permanent scarring in your lungs (pulmonary fibrosis), making it difficult to breathe and sometimes causing pulmonary hypertension.
Inflammation can affect almost any part of your eye and may cause damage to the retina, which can eventually cause blindness. Rarely, sarcoidosis also can cause cataracts and glaucoma.
Sarcoidosis can affect how your body handles calcium, which can lead to kidney stones and reduce kidney function. Rarely, this can lead to kidney failure.
Cardiac sarcoidosis results in granulomas in your heart that can disrupt heart rhythm, blood flow and normal heart function. In rare instances, this may lead to death.
• Nervous system.
A small number of people with sarcoidosis develop problems related to the central nervous system when granulomas form in the brain and spinal cord. Inflammation in the facial nerves, for example, can cause facial paralysis.
• Men Infertility.
Infertility in men or difficulty conceiving due to sarcoidosis affecting the testes
It can be difficult to diagnose sarcoidosis. Symptoms can be similar to those of other diseases, such as arthritis or cancer. Your doctor will run a variety of tests to make a diagnosis.
Your doctor will first perform a physical examination to:
• check for skin bumps or a rash
• look for swollen lymph nodes
• listen to your heart and lungs
• check for an enlarged liver or spleen
Based on the findings, your doctor may order additional diagnostic tests:
• A chest X-ray can be used to check for granulomas and swollen lymph nodes.
• A chest CT scan is an imaging test that takes cross-sectional pictures of your chest.
• A lung function test can help determine whether your lung capacity has become affected.
• A biopsy involves taking a sample of tissue that can be checked for granulomas.
Your doctor may also order blood tests to check your kidney and liver function.
There’s no cure for sarcoidosis. However, some people do not need treatment for sarcoidosis. Symptoms often improve without treatment. This is called “spontaneous remission.”
Treatment may be needed if the disease affects your:
• nervous system
If you do need treatment, your doctor will assess your symptoms and how advanced the condition is. They may prescribe medications to help suppress the immune system and reduce inflammation. This can ease the symptoms of sarcoidosis.
Medications used to treat sarcoidosis include:
• Corticosteroids. Prednisone is the most commonly prescribed treatment for sarcoidosis. However, the side effects of this medication can be severe, so it may only be prescribed for a short period of time.
• Disease modifying antirheumatic drugs (DMARDs). DMARDs are medications that suppress the immune system. They may slow the progression of sarcoidosis and reduce symptoms. Examples include methotrexate (Trexall), azathioprine (Azasan), and leflunomide (Arava).
• Antimalarial agents. Medications like hydroxychloroquine (Plaquenil) may be helpful for sarcoidosis symptoms that affect the skin and joints.
• Biologic agents. These medications are used to stop an overactive immune system. They have significant side effects, so they’re typically reserved for people whose bodies do not tolerate other medications. Examples include rituximab (Rituxan), infliximab (Remicade), and golimumab (Simponi).
The length of any treatment will vary. Some people take medication for 1 to 2 years. Other people may need to take medication for much longer.
Ayurvedic Perspective –
According to ayurveda , Sarcodoisis is a condition that can be co- related with Dhatugat vikar and generation of endotoxins in the body is responsible for sarcoidosis . These endotoxins are known as Ama in the ayurveda . The accumulation of the Ama in the circulatory and lymphatic system leads to disturbance of immune system of the body and alter functioning.
After knowing the cause it can , this disorder can be well managed by Ayurveda. In Ayurveda Treatment of sarcoidosis is done by combination of shodhan chikitisa and shaman chikitisa.
▪︎ Shodhan chikitisa involves procedure of asthapana basti or kashaya basti . This is done after evaluating the prakriti of patient and severity of the disease. With this some combination of medicines is also used to see effective results in patients.
▪︎ Rasayan therapy is also done after shodhan chikitisa. Beside of these , some life style and dietary modification are also advised.
▪︎ Some Ayurvedic herbs for shaman chikitsa that are useful in Sarcoidosis are –
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