General Practice 2022

Sarcoidosis: what é, symptoms, causes and treatment

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Sarcoidosis: what é, symptoms, causes and treatment
Sarcoidosis: what é, symptoms, causes and treatment

Sarcoidosis is an inflammatory disease characterized by the formation of clusters of inflammatory cells, called granuloma, in various parts of the body, such as the lungs, liver, skin or eyes, leading to symptoms such as sore tongues, excessive tiredness., joint pain or swelling, for example.

The cause of sarcoidosis is not known, however, it is believed that it may be caused by an exaggerated response of the immune system to microorganisms or chemicals, or even by a production of antibodies that end up attacking he althy cells of the body, causing inflammation.

The treatment of sarcoidosis should be performed by a rheumatologist or general practitioner, with the aim of relieving symptoms and avoiding possible complications, such as respiratory or renal failure, pulmonary hypertension, blindness or paraplegia, for example.

Main symptoms

Symptoms of sarcoidosis depend on the organ affected, and may suddenly and also improve quickly, or come on gradually and last for several years. Major ones include:

  • Languages ​​in various locations, such as armpits or neck;
  • Red, painful lumps or lumps on the skin;
  • Red spots on the skin and color change;
  • Excessive fatigue;
  • Pain, itching, dryness or burning sensation in the eye;
  • Vision blurred;
  • Pain or swelling in joints;
  • Weight loss for no apparent reason;
  • Persistent dry cough
  • Difficulty breathing;
  • Wheezing in the chest;
  • Chest pain;
  • Hearing loss;
  • Seizures;
  • Heart palpitation;
  • Irregular heartbeat.

It is important to consult a general practitioner or a rheumatologist whenever symptoms suggestive of sarcoidosis appear, so that other causes can be ruled out, the diagnosis confirmed and the most appropriate treatment initiated.

How to confirm the diagnosis

Sarcoidosis is not an easily diagnosed condition, as in the early stages it may not have symptoms and, in the more advanced stages, it may have symptoms similar to other diseases such as tuberculosis, lymphoma or lung cancer, for example.

Therefore, the diagnosis of sarcoidosis is usually made by the general practitioner or rheumatologist through the evaluation of symptoms, physical examination and the performance of various tests such as complete blood count, liver function tests or urinalysis.

In addition, the doctor may order pulmonary function tests, such as spirometry, and imaging tests such as chest X-rays or CT scans to evaluate the lungs, as the lung is the most frequently affected organ in this disease..See what spirometry is and how it's done.

Other tests that the doctor may order to evaluate the heart, nervous system or other organs are electrocardiogram, echocardiogram, magnetic resonance imaging or PET-CT.

In some cases, the doctor may also order a biopsy of the region affected by sarcoidosis, such as the skin, lungs, or lymph nodes, to evaluate the cells under a microscope and diagnose sarcoidosis.

Main types of sarcoidosis

Sarcoidosis can affect different organs, and therefore it is classified according to the affected organ, the main types being:

  • Pulmonary sarcoidosis: is the most common type, affecting the lungs, occurring in more than 90% of sarcoidosis cases;
  • Cutaneous sarcoidosis: this type affects the skin, and the lesions can appear at the eyebrow level and also affect the nasolabial fold, which is popularly known as Chinese mustache, happening in more than 30% of people diagnosed with sarcoidosis;
  • Cardiac sarcoidosis: affects the heart, interfering with the electrical signals that coordinate the contraction of the heart muscle, occurring in about 5% of sarcoidosis cases;
  • Ocular sarcoidosis: affects the eyes, causing uveitis, which is an inflammation of the eyes, and generally, this condition is present in about 80% of cases of ocular sarcoidosis. Understand better what uveitis is;
  • Hepatic sarcoidosis: affects the liver, can occur in up to 70% of sarcoidosis cases, and is usually detected in routine liver function tests, although not affect liver function. Still, in rare cases, it can cause cirrhosis or portal hypertension.

Also, although less common, sarcoidosis can also affect the spleen, kidneys, muscles, bones, or nervous system.

Possible causes

The causes of sarcoidosis are not fully known, however, it is believed that the condition may be related to the immune system's exaggerated response to microorganisms such as mycobacteria or propionibacteria, chemicals such as beryllium, or even dust.

In addition, there is still the possibility that sarcoidosis is caused by a reaction of the immune system against the body's own he althy cells, attacking these cells as if they were foreign to the body, which leads to inflammation and formation of granulomas, characteristic of sarcoidosis, in different organs.

Although there is no specific cause identified, it is known that sarcoidosis is related to genetic factors and, therefore, is more likely to occur in several members of the same family.

How the treatment is done

The treatment of sarcoidosis is performed by the general practitioner or rheumatologist with the aim of relieving symptoms, preventing disease progression and the emergence of complications.

This way, the doctor can prescribe the use of medications such as:

  • Anti-inflammatories or pain relievers, such as acetaminophen or ibuprofen;
  • Corticoids in pill form, such as prednisone, or corticosteroid ointments or eye drops;
  • Immunosuppressants, such as azathioprine, methotrexate or hydroxychloroquine;
  • Biological agents, such as infliximab or adalimumab.

In addition, the doctor may recommend other treatments, depending on the affected organ, and physiotherapy may be indicated to strengthen the muscles, pulmonary rehabilitation, in the case of pulmonary sarcoidosis or the use of a pacemaker, in the case of cardiac sarcoidosis, for example.

It is also recommended that the person diagnosed with sarcoidosis be monitored periodically by the doctor, even if they do not have symptoms, so that the evolution of the disease and the response to treatment can be verified.

In the case of severe organ impairment, the doctor may also recommend performing a transplant of the affected organ, such as a lung, kidney, spleen or liver, for example. Learn how lung transplantation is performed.

Possible complications

Complications of sarcoidosis depend on the organ affected, and there may be fibrosis or pulmonary hypertension, respiratory failure, cataract, glaucoma, blindness, renal failure, cardiac arrhythmia, facial paralysis or even paraplegia.

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