Table of ContentsView AllTable of ContentsWhat Is Sarcoidosis?SymptomsStagesCausesDiagnosisTreatmentDisease ManagementPrognosisCoping
Table of ContentsView All
View All
Table of Contents
What Is Sarcoidosis?
Symptoms
Stages
Causes
Diagnosis
Treatment
Disease Management
Prognosis
Coping
Sarcoidosisis a systemic (whole-body) inflammatory disease that develops when groups of cells in the immune system form clumps calledgranulomasin various parts of the body.
The condition can affect any organ, but cases are typically found in the lungs. Some cases of sarcoidosis are mild and do not require treatment, but some can be life-threatening and result in permanent organ damage.
This article explains what sarcoidosis is, as well as its symptoms, causes, and complications. It also covers how the condition is diagnosed and treated and how to cope if you’re living with it.
Sarcoidosis is a disease in which the immune system overreacts, causing while blood cells in the body to form clusters of inflamed tissue, or granulomas.
Granulomas most commonly affect the lungs and lymph nodes, but sarcoidosis can affect any organ including the eyes, skin, heart and nervous system.
Sarcoidosis is a rare disease. Research estimates that there are fewer than 200,000 cases each year in the United States.
The incidence of the disease is much higher among African Americans compared with Caucasians, and African Americans are more likely to have a more severe form of sarcoidosis. In severe cases, sarcoidosis can be life-threatening.
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Sarcoidosis Symptoms
There are nine types of sarcoidosis, each affecting a different part of the body.
The symptoms of sarcoidosis will differ depending on where in the body granulomas have formed, but all forms of the disease can present with similar symptoms. Sometimes people with the condition will be asymptomatic, making sarcoidosis hard to diagnose.
General Symptoms
Verywell / Michela Buttignol
The general symptoms of sarcoidosis are nonspecific and can sometimes be confused with those of other conditions. The most common initial symptoms of sarcoidosis include:
Granuloma Symptoms and Related Conditions
Lung Symptoms
The symptoms of pulmonary sarcoidosis will not appear in everyone with the condition and will range in severity depending on the severity of the disease. The most common symptoms include:
Other symptoms that aren’t related to the lungs but can appear in pulmonary sarcoidosis include:
Sarcoidosis affects the lungs in 90% of all cases.Around 10% to 20% of people with sarcoidosis will develop treatment-resistant pulmonary disease like pulmonary fibrosis and pulmonary hypertension, which are the leading cause of death from sarcoidosis.
Liver Symptoms
Hepatic sarcoidosis occurs in the liver.The liver can become enlarged, and people with this type of sarcoidosis will have abnormal liver tests orcirrhosis.
Renal Symptoms
When granulomas form in the kidneys, it can lead to:
Cardiac Symptoms
The main symptoms of cardiac sarcoidosis include:
Eye Symptoms
Ocular/eye sarcoidosiscan lead to the following symptoms:
Ocular sarcoidosis can lead touveitis, which is inflammation of the eye that can cause vision loss and eye pain.
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Skin Symptoms
The skin symptoms of sarcoidosis include:
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Neurosarcoidosis Symptoms
This type of sarcoidosis is chronic and affects the central nervous system, including the brain, spinal cord, and optic nerve. Symptoms include:
Musculoskeletal Symptoms
It is rare for sarcoidosis to affect the musculoskeletal system, but when it does it can lead to:
Spleen and Bone Marrow Symptoms
When sarcoidosis affects the spleen and bone marrow, it can lead to health issues likeanemiaandleukopenia.
Stages of Sarcoidisis
Based on a chest X-ray, sarcoidosis in the lungs is assigned a “Scadding stage” ranging from 0 to 4. The location of the granulomas in the lungs and lymph nodes are used to predict the chance of the disease resolving on its own, with lower stages being more likely to not need treatment.
Symptoms can be serious at any stage. Patients at any stage can experience involvement of other organs.
Although there is no known cause for any type of sarcoidosis, it is thought that both genetics and environmental factors play a role in its development.It is suggested that when someone whose genes make them more prone to developing sarcoidosis is exposed to a trigger such as an infection or environmental contaminant, their immune system can overreact and trigger the disease.
Some studies have found antibodies against human proteins at increased rates in some patients with sarcoidosis compared to others with and without sarcoidosis.
The cells from some people with sarcoidosis also demonstrate an immune response to some of their own proteins, similar to autoimmune diseases. The exact role of autoimmunity in sarcoidosis is not clear yet.
Risk Factors
Certain factors may lead to a higher risk of developing sarcoidosis, including:
Diagnosingsarcoidosisis often challenging because there is no single blood or imaging test that can confirm the diagnosis.
Instead, the diagnosis of sarcoidosis is based on four main factors:
Given that sarcoidosis may not present with symptoms, the disease is sometimes discovered incidentally when a person has a physical exam or a chest X-ray for some other reason.
Physical Exam
In addition, a patient’s age and race can provide a clue to the potential diagnosis.
When it comes to the physical exam, signs of sarcoidosis are often subtle or nonspecific, such as wheezing heard in the lungs.
That said, in some cases, the physical exam findings are more obvious. And if they are found in combination (for example, the eruption of an erythema nodosum rash, along with a fever and multiple joint pains), the diagnosis of sarcoidosis becomes more evident.
Medical Tests
A variety of imaging and other tests are usually performed to help make the diagnosis of sarcoidosis.
These tests often include the following:
Verywell / Gary Ferster
Biopsy
Once the tissue sample is removed, it is examined under a microscope for the characteristic finding of sarcoidosis—a granuloma.
Differential Diagnoses
Since several other diseases can mimic the symptoms and signs of sarcoidosis, your healthcare provider will evaluate these alternative diagnoses:
Treating Sarcoidosis
There is no cure for sarcoidosis, but the condition sometimes resolves without medical intervention. For those who do require treatment, the severity of symptoms will be the deciding factor in the type of treatment used.
Medications
If a case of sarcoidosis is particularly severe, medication will likely be prescribed to help combat symptoms and slow the progression of the disease. Some medications used in the treatment of sarcoidosis include:
Other Treatments
Depending on what part of the body is affected, the treatments may vary. Some possible treatments for more progressed stages of sarcoidosis include:
Managing Sarcoidosis
At-Home Care
Lifestyle modifications can help you stay as healthy as possible with sarcoidosis. These include:
Ongoing Monitoring
It’s important to stay on top of any new symptoms that may develop. Likewise, note if your disease seems to go into remission.
Stay in touch with your healthcare provider and keep them informed. This way, if your disease worsens, they can come up with appropriate treatment. If it goes into remission, your provider may want to see how you do if treatment is paused or stopped.
The prognosis for people with sarcoidosis differs depending on symptoms, the level of damage done to the body, and the type of sarcoidosis they have.
For many, recovery typically occurs on its own without medical intervention. In about 60% of cases, the granulomas will disappear over two to five years and the patient will recover.
In rare cases, the condition can lead to death if the body is damaged irreparably (and there is severe scarring of the lungs, for example). However, that only occurs in roughly 1% to 8% of sarcoidosis cases.
If no treatment is required, you should see your healthcare provider for regular check-ups to ensure that it is monitored accordingly and isn’t progressing.
Sarcoidosis comes with health challenges that can be difficult to cope with. A support group can be a big help in coping with the condition and the effects on your life. The Foundation for Sarcoidosis Research has an online database that can help connect people with sarcoidosis with a support group in their local area.
Managing a chronic condition like sarcoidosis can be physically and mentally taxing, so self-care is an important component of coping with the disease. Consider discussing symptoms with loved ones and finding creative outlets for stress like painting and journaling.
Summary
Sarcoidosis is an inflammatory disease that causes white blood cells to form into clusters called granulomas. The disease most commonly affects the lungs, but can also affect other organs, such as the liver, kidneys, eyes, and heart.
Symptoms vary according to which organ is affected, and the disease can range from mild to potentially life-threatening. Some cases of sarcoidosis may resolve on their own, while others will require ongoing treatment.
A Word From VerywellWhile principally in the lungs and lymph nodes, the organs in which inflammatory cell collections from sarcoidosis are located predict the symptoms, which can include no symptoms, swollen lymph nodes, wheezing, kidney stones, chest pain, blurred vision, skin nodules, hearing loss, or bone loss. Biopsy is very informative for the diagnosis, and there are several treatments available, including no treatment, as the condition has been known to remit without any intervention.—STEFFINI STALOS, DO, MEDICAL EXPERT BOARD
A Word From Verywell
While principally in the lungs and lymph nodes, the organs in which inflammatory cell collections from sarcoidosis are located predict the symptoms, which can include no symptoms, swollen lymph nodes, wheezing, kidney stones, chest pain, blurred vision, skin nodules, hearing loss, or bone loss. Biopsy is very informative for the diagnosis, and there are several treatments available, including no treatment, as the condition has been known to remit without any intervention.—STEFFINI STALOS, DO, MEDICAL EXPERT BOARD
While principally in the lungs and lymph nodes, the organs in which inflammatory cell collections from sarcoidosis are located predict the symptoms, which can include no symptoms, swollen lymph nodes, wheezing, kidney stones, chest pain, blurred vision, skin nodules, hearing loss, or bone loss. Biopsy is very informative for the diagnosis, and there are several treatments available, including no treatment, as the condition has been known to remit without any intervention.
—STEFFINI STALOS, DO, MEDICAL EXPERT BOARD
20 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Lung Association.Learn about sarcoidosis.Gerke AK, Judson MA, Cozier YC, Culver DA, Koth LL.Disease burden and variability in sarcoidosis.Ann Am Thorac Soc.14(Supplement_6):S421-S428. doi:10.1513/AnnalsATS.201707-564OTAmerican Lung Association.Learn about sarcoidosis.National Heart, Lung, and Blood Association.Sarcoidosis.Johns Hopkins Medicine.Pulmonary sarcoidosis.Michigan Medicine.Sarcoidosis.Tadros M, Forouhar F, Wu GY.Hepatic sarcoidosis. 2013.J Clin Transl Hepatol.1(2):87-93. doi:10.14218/JCTH.2013.00016Bergner R, Löffler C.Renal sarcoidosis: approach to diagnosis and management.Curr Opin Pulm Med.2018. 24(5):513-520. doi:10.1097/MCP.0000000000000504Foundation for Sarcoidosis Research.Understanding cardiac sarcoidosis: diagnosis and treatment.Yang SJ, Salek S, Rosenbaum JT.Ocular sarcoidosis: new diagnostic modalities and treatment.Curr Opin Pulm Med. 23(5):458-467. Sept 2017 doi: 10.1097/MCP.0000000000000409Reddy RR, Shashi Kumar BM, Harish MR.Cutaneous sarcoidosis - a great masquerader: a report of three interesting cases. Sept-Oct 2023.Indian J Dermatol.56(5):568-72. doi:10.4103/0019-5154.87158Cedars-Sinai.Neurosarcoidosis.Strookappe B, Swigris J, De Vries J, Elfferich M, Knevel T, Drent M.Benefits of physical training in sarcoidosis.Lung.2015. 193(5):701-8. doi:10.1007/s00408-015-9784-9Peña-Garcia JI, Shaikh S, Barakoti B, Papageorgiou C, Lacasse A.Bone marrow involvement in sarcoidosis: an elusive extrapulmonary manifestation.J Community Hosp Intern Med Perspect.9(2):150-154. doi:10.1080/20009666.2019.1575688Foundation of Sarcoidosis Research.Causes and risk factors.Asakawa N, Uchida K, Sakakibara M, Omote K, Noguchi K, et al.Immunohistochemical identification of Propionibacterium acnes in granuloma and inflammatory cells of myocardial tissues obtained from cardiac sarcoidosis patients.PLoS One.July 2017. 12(7):e0179980. doi:10.1371/journal.pone.0179980American Lung Association.Treating and managing sarcoidosis.Soto-Gomez N, Peters JI, Nambiar AM.Diagnosis and management of sarcoidosis.Am Fam Physician.93(10):840-8Foundation for Sarcoidosis Research.Prognosis.Baughman RP, Judson MA, Teirstein A, Yeager H, Rossman M, Knatterud GL, Thompson B.Presenting characteristics as predictors of duration of treatment in sarcoidosis.QJM.99(5):307-15. doi:10.1093/qjmed/hcl038Additional ReadingCleveland Clinic.Sarcoidosis.
20 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Lung Association.Learn about sarcoidosis.Gerke AK, Judson MA, Cozier YC, Culver DA, Koth LL.Disease burden and variability in sarcoidosis.Ann Am Thorac Soc.14(Supplement_6):S421-S428. doi:10.1513/AnnalsATS.201707-564OTAmerican Lung Association.Learn about sarcoidosis.National Heart, Lung, and Blood Association.Sarcoidosis.Johns Hopkins Medicine.Pulmonary sarcoidosis.Michigan Medicine.Sarcoidosis.Tadros M, Forouhar F, Wu GY.Hepatic sarcoidosis. 2013.J Clin Transl Hepatol.1(2):87-93. doi:10.14218/JCTH.2013.00016Bergner R, Löffler C.Renal sarcoidosis: approach to diagnosis and management.Curr Opin Pulm Med.2018. 24(5):513-520. doi:10.1097/MCP.0000000000000504Foundation for Sarcoidosis Research.Understanding cardiac sarcoidosis: diagnosis and treatment.Yang SJ, Salek S, Rosenbaum JT.Ocular sarcoidosis: new diagnostic modalities and treatment.Curr Opin Pulm Med. 23(5):458-467. Sept 2017 doi: 10.1097/MCP.0000000000000409Reddy RR, Shashi Kumar BM, Harish MR.Cutaneous sarcoidosis - a great masquerader: a report of three interesting cases. Sept-Oct 2023.Indian J Dermatol.56(5):568-72. doi:10.4103/0019-5154.87158Cedars-Sinai.Neurosarcoidosis.Strookappe B, Swigris J, De Vries J, Elfferich M, Knevel T, Drent M.Benefits of physical training in sarcoidosis.Lung.2015. 193(5):701-8. doi:10.1007/s00408-015-9784-9Peña-Garcia JI, Shaikh S, Barakoti B, Papageorgiou C, Lacasse A.Bone marrow involvement in sarcoidosis: an elusive extrapulmonary manifestation.J Community Hosp Intern Med Perspect.9(2):150-154. doi:10.1080/20009666.2019.1575688Foundation of Sarcoidosis Research.Causes and risk factors.Asakawa N, Uchida K, Sakakibara M, Omote K, Noguchi K, et al.Immunohistochemical identification of Propionibacterium acnes in granuloma and inflammatory cells of myocardial tissues obtained from cardiac sarcoidosis patients.PLoS One.July 2017. 12(7):e0179980. doi:10.1371/journal.pone.0179980American Lung Association.Treating and managing sarcoidosis.Soto-Gomez N, Peters JI, Nambiar AM.Diagnosis and management of sarcoidosis.Am Fam Physician.93(10):840-8Foundation for Sarcoidosis Research.Prognosis.Baughman RP, Judson MA, Teirstein A, Yeager H, Rossman M, Knatterud GL, Thompson B.Presenting characteristics as predictors of duration of treatment in sarcoidosis.QJM.99(5):307-15. doi:10.1093/qjmed/hcl038Additional ReadingCleveland Clinic.Sarcoidosis.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Lung Association.Learn about sarcoidosis.Gerke AK, Judson MA, Cozier YC, Culver DA, Koth LL.Disease burden and variability in sarcoidosis.Ann Am Thorac Soc.14(Supplement_6):S421-S428. doi:10.1513/AnnalsATS.201707-564OTAmerican Lung Association.Learn about sarcoidosis.National Heart, Lung, and Blood Association.Sarcoidosis.Johns Hopkins Medicine.Pulmonary sarcoidosis.Michigan Medicine.Sarcoidosis.Tadros M, Forouhar F, Wu GY.Hepatic sarcoidosis. 2013.J Clin Transl Hepatol.1(2):87-93. doi:10.14218/JCTH.2013.00016Bergner R, Löffler C.Renal sarcoidosis: approach to diagnosis and management.Curr Opin Pulm Med.2018. 24(5):513-520. doi:10.1097/MCP.0000000000000504Foundation for Sarcoidosis Research.Understanding cardiac sarcoidosis: diagnosis and treatment.Yang SJ, Salek S, Rosenbaum JT.Ocular sarcoidosis: new diagnostic modalities and treatment.Curr Opin Pulm Med. 23(5):458-467. Sept 2017 doi: 10.1097/MCP.0000000000000409Reddy RR, Shashi Kumar BM, Harish MR.Cutaneous sarcoidosis - a great masquerader: a report of three interesting cases. Sept-Oct 2023.Indian J Dermatol.56(5):568-72. doi:10.4103/0019-5154.87158Cedars-Sinai.Neurosarcoidosis.Strookappe B, Swigris J, De Vries J, Elfferich M, Knevel T, Drent M.Benefits of physical training in sarcoidosis.Lung.2015. 193(5):701-8. doi:10.1007/s00408-015-9784-9Peña-Garcia JI, Shaikh S, Barakoti B, Papageorgiou C, Lacasse A.Bone marrow involvement in sarcoidosis: an elusive extrapulmonary manifestation.J Community Hosp Intern Med Perspect.9(2):150-154. doi:10.1080/20009666.2019.1575688Foundation of Sarcoidosis Research.Causes and risk factors.Asakawa N, Uchida K, Sakakibara M, Omote K, Noguchi K, et al.Immunohistochemical identification of Propionibacterium acnes in granuloma and inflammatory cells of myocardial tissues obtained from cardiac sarcoidosis patients.PLoS One.July 2017. 12(7):e0179980. doi:10.1371/journal.pone.0179980American Lung Association.Treating and managing sarcoidosis.Soto-Gomez N, Peters JI, Nambiar AM.Diagnosis and management of sarcoidosis.Am Fam Physician.93(10):840-8Foundation for Sarcoidosis Research.Prognosis.Baughman RP, Judson MA, Teirstein A, Yeager H, Rossman M, Knatterud GL, Thompson B.Presenting characteristics as predictors of duration of treatment in sarcoidosis.QJM.99(5):307-15. doi:10.1093/qjmed/hcl038
American Lung Association.Learn about sarcoidosis.
Gerke AK, Judson MA, Cozier YC, Culver DA, Koth LL.Disease burden and variability in sarcoidosis.Ann Am Thorac Soc.14(Supplement_6):S421-S428. doi:10.1513/AnnalsATS.201707-564OT
National Heart, Lung, and Blood Association.Sarcoidosis.
Johns Hopkins Medicine.Pulmonary sarcoidosis.
Michigan Medicine.Sarcoidosis.
Tadros M, Forouhar F, Wu GY.Hepatic sarcoidosis. 2013.J Clin Transl Hepatol.1(2):87-93. doi:10.14218/JCTH.2013.00016
Bergner R, Löffler C.Renal sarcoidosis: approach to diagnosis and management.Curr Opin Pulm Med.2018. 24(5):513-520. doi:10.1097/MCP.0000000000000504
Foundation for Sarcoidosis Research.Understanding cardiac sarcoidosis: diagnosis and treatment.
Yang SJ, Salek S, Rosenbaum JT.Ocular sarcoidosis: new diagnostic modalities and treatment.Curr Opin Pulm Med. 23(5):458-467. Sept 2017 doi: 10.1097/MCP.0000000000000409
Reddy RR, Shashi Kumar BM, Harish MR.Cutaneous sarcoidosis - a great masquerader: a report of three interesting cases. Sept-Oct 2023.Indian J Dermatol.56(5):568-72. doi:10.4103/0019-5154.87158
Cedars-Sinai.Neurosarcoidosis.
Strookappe B, Swigris J, De Vries J, Elfferich M, Knevel T, Drent M.Benefits of physical training in sarcoidosis.Lung.2015. 193(5):701-8. doi:10.1007/s00408-015-9784-9
Peña-Garcia JI, Shaikh S, Barakoti B, Papageorgiou C, Lacasse A.Bone marrow involvement in sarcoidosis: an elusive extrapulmonary manifestation.J Community Hosp Intern Med Perspect.9(2):150-154. doi:10.1080/20009666.2019.1575688
Foundation of Sarcoidosis Research.Causes and risk factors.
Asakawa N, Uchida K, Sakakibara M, Omote K, Noguchi K, et al.Immunohistochemical identification of Propionibacterium acnes in granuloma and inflammatory cells of myocardial tissues obtained from cardiac sarcoidosis patients.PLoS One.July 2017. 12(7):e0179980. doi:10.1371/journal.pone.0179980
American Lung Association.Treating and managing sarcoidosis.
Soto-Gomez N, Peters JI, Nambiar AM.Diagnosis and management of sarcoidosis.Am Fam Physician.93(10):840-8
Foundation for Sarcoidosis Research.Prognosis.
Baughman RP, Judson MA, Teirstein A, Yeager H, Rossman M, Knatterud GL, Thompson B.Presenting characteristics as predictors of duration of treatment in sarcoidosis.QJM.99(5):307-15. doi:10.1093/qjmed/hcl038
Cleveland Clinic.Sarcoidosis.
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