Sarcoidosis is a "multiorgan"
disease - meaning it almost always involves more than one
organ. An organ is affected when granulomas (masses of
inflamed tissue, or lumps) form and cause an abnormality.
Many sarcoidosis patients do not have any symptoms. Some
have only one symptom, while still others have several.
General symptoms caused by the disease include fever,
tiredness or fatigue, weight loss, night sweats and an overall feeling of
ill health. Other symptoms typically depend on which organs
the disease affects.
Symptoms
Some organs are affected more
often than others. Sarcoidosis occurs most often in the
lungs. It also commonly affects the skin, eyes, lymph nodes
and liver. Less commonly, it affects the spleen, brain,
nerves, heart, tear glands, salivary glands, sinuses, bones
and joints. Rarely, it affects other organs, such as the
kidneys, breasts and male and female reproductive organs.
Often, the effects of sarcoidosis in an organ are so mild
that there are no symptoms and the organ continues to
function well.
Lungs: The lungs are the most commonly affected organ
in sarcoidosis. Ninety percent or more of people with
sarcoidosis have lung involvement, whether they have
symptoms or not. Common lung symptoms are dry
coughing, trouble breathing, wheezing, or pain with
breathing, chest pain, tightness, or discomfort and coughing
up blood, which is rare, especially in the early stages of
sarcoidosis.
Lymph Nodes: Lymph
nodes are glands found throughout the body that make and
store white blood cells. When sarcoidosis inflammation
targets these glands, they become enlarged. Swollen lymph
nodes can be uncomfortable, but they rarely cause medical
problems unless they press on organs or blood vessels.
Most commonly, it’s the lymph glands in the chest that are
affected. Some of the other places you might notice enlarged
lymph nodes (they appear as swollen lumps) include your
neck, under your chin, in your armpit and in your groin.
Spleen: The spleen is a large organ on the left side
of the body under the ribs that produces and filters red
blood cells and some types of white blood cells. Along with
the lymph nodes, the spleen is part of the lymphatic system,
which regulates blood cells and plays a role in immunity.
Sarcoidosis of the spleen does not usually cause symptoms.
If you do notice symptoms, they might include pain or
pressure on your upper left side under your ribs or feeling
tired.
Liver: Sarcoidosis granulomas can cause the
liver to enlarge. The disease rarely causes serious
liver problems, however, and most people do not even realize
it when their livers are affected. If you have liver
symptoms, they might include fever, feeling tired or
fatigued, itchy skin, jaundice, which causes your skin and
eyes to look somewhat yellow, pain on your upper right side
under your ribs.
Heart:
Some people with heart involvement might notice symptoms,
but many people will feel nothing, even in late-stage
disease. Because heart problems can be very serious,
everyone who has sarcoidosis should be screened for cardiac
involvement. Sarcoidosis can cause the heart to pump weakly. This
results in such symptoms as shortness of breath, swelling of
the legs, wheezing and coughing - although these can be a
sign of lung problems too. Sarcoidosis also can affect
the heart’s electrical pacing and transmission system, which
tells the heart when to beat. This can make the heart beat
too fast or very slowly or skip beats. Symptoms of an
electrical-system problem include palpitations (a fluttering
sensation of rapid heartbeats), skipped beats and, rarely,
fluid buildup in the lungs or sudden loss of consciousness. Find out more about cardiac
sarcoidosis and its symptoms.
Brain & Nervous System: The nervous system includes the brain
and all the body’s nerves, and it may be affected by
sarcoidosis. The disease can cause a mass of granulomas in
the brain or meninges, which are the membranes that cover
the brain. The disease also can affect one or more nerves
anywhere in the body. Most often, it affects the nerves of
the face. Symptoms of the disease in the nervous system
vary. If there is a mass in the brain, symptoms can include
headaches, visual problems and weakness or numbness of an
arm or leg. When sarcoidosis affects a facial nerve, it can
cause one side of the face to droop. This may be the first
symptom that someone has sarcoidosis. When sarcoidosis
affects the spinal cord, it can cause weakness or even
paralysis of the arms or legs. When multiple nerves in more
than one place are affected, the disease can cause weakness,
pain, or a "stinging needles" sensation in those areas.
Skin: Sarcoidosis of the skin can result in rashes or
various types of skin lesions. If you have one of
these skin problems it can be a clue to how serious your
case of sarcoidosis is. One type of lesion is called erythema nodosum
which causes raised, red, and tender bumps to form on the
skin, usually on the front of your legs. Nearby joints are
often swollen and painful. Erythema nodosum usually goes
away on its own in 6 to 8 weeks, even without treatment.
Having it is a good sign that you might have the type of
sarcoidosis that also goes away on its own after a few
months or years. Lupus pernio is an uncommon
skin condition that causes hard, reddish-purplish bumps to
form on your cheeks, nose, lips, and/or ears. These bumps do
not go away on their own and often come back when treatment
is stopped. They are usually associated with chronic
sarcoidosis. In some cases, the sores are disfiguring and
can damage underlying cartilage and bone. Other
lesions may appear as bumps on or under the skin, rashes,
sores, scaling, and/or changes in old scars or tattoos that
do not go away and are rarely painful or itchy. These skin
problems are also associated with chronic sarcoidosis.
Bones, Joints & Muscles: Musculoskeletal
sarcoidosis (musculo=muscles, joints and bones=skeletal) can
result in a number of symptoms. Early-onset
arthritis, which is joint pain, stiffness, and/or
swelling that usually occurs in the first 6 months of the
disease, begins suddenly in one or both of the ankles and/or
feet, and sometimes involves the knees, toes, fingers,
wrists, and/or elbow joints. It often accompanies erythema
nodosum, and it usually goes away on its own in a few weeks
or months. Late-onset arthritis, which usually
occurs 6 months or more after sarcoidosis develops, is less
painful and affects fewer joints than early-onset arthritis
(usually the knees and/or ankles, or sometimes the fingers
or toes), and is often associated with chronic skin symptoms
rather than erythema nodosum. This type of arthritis can
last a long time or a lifetime, or it may come and go, but
it usually does not go away for good without treatment like
early-onset arthritis does. It can cause permanent joint
damage and should be treated even when it is not painful.
Sarcoidosis also can affect the bone marrow (soft, organic
material that fills bone cavities), which produces blood
cells. This can result in anemia, in which there are too few
red blood cells, or a lowered number of white blood cells.
Red blood cells are needed to deliver oxygen to the body;
white blood cells help fight infections. In muscles,
sarcoidosis may cause muscle aches or muscle pain (also
called myalgia) or muscle weakness. The disease can also
cause bone cysts, which are rare.
Eyes: 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.
Kidneys & Urinary Tract: Sarcoidosis rarely attacks the kidneys directly. However,
the disease can cause the body to overproduce vitamin D,
which in turn causes the body to absorb too much calcium and
can lead to kidney stones. Although they are uncommon in
sarcoidosis, kidney stones can be painful when they break
loose from the kidney and pass into the bladder, so it is a
good idea to ask your doctor to check you for excess calcium
before kidney stones have the chance to develop.
Symptoms of kidney stones you might notice include pain in
your back or side, or an increased urge to urinate.
Salivary Glands: Inflammation in the salivary glands
can sometimes cause painful dryness in the mouth. When
sarcoidosis affects these glands, it can make your cheeks
look swollen.
Sinuses: Sarcoidosis can also cause
inflammation of the sinuses (called sinusitis). Symptoms
include a runny nose, stuffiness, and sinus pain or
headache. The sinusitis associated with sarcoidosis is often
chronic and can be very troublesome, although it is rarely
serious.
Mental Health:
Research shows that more than half of people with
sarcoidosis symptoms also show signs of clinical depression.
Depression can affect your work, your studies, how well you
sleep, and even your appetite. Persistent feelings of
sadness, emptiness, and anxiety are all signs of depression
that you should talk to your doctor about. Certainly if you
are having suicidal thoughts you should tell your doctor.
Depression is treatable. Medications and/or talk therapy are
often helpful.
The preceding
information relating to symptoms of sarcoidosis is excerpted from the FSR
publication 'Sarcoidosis and the Body', © 2007. Click Here to order your free copy. |