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Sarcoidosis (Besnier-Boeck-Schaumann disease)

Sarcoidosis, also referred to as Besnier-Boeck-Schaumann disease, is characterised by the build-up of inflammatory cells or granulomata in various parts of the body, but most often in the lungs, lymph nodes, eyes and skin.

A diagram showing the symptoms of sarcoidosis

Sarcoidosis is believed to be an immune response to a foreign substance, possibly inhaled from the air (bacteria, dust or chemicals), but research is ongoing to its exact causes. Often, it clears up on it’s own, but in some cases (around 15%) it may become chronic with symptoms lasting for years.

Although it is rarely fatal, chronic sarcoidosis may lead to organ damage, specifically of the brain, lungs and heart. 

Sarcoidosis occurs more commonly in individuals between the ages of 20 and 40. 

What are its symptoms?

Sarcoidosis symptoms vary, depending on which organs are affected. Generally, individuals will experience fatigue, shortness of breath, wheezing and an ongoing dry cough

Additional symptoms may include:

  • Weight loss
  • Chest pain
  • Eye symptoms that include blurred vision, red and teary eyes, eye pain
  • Rash (also known as contact dermatitis) on the shin or ankles, or lesions on the nose, cheeks or ears
  • Swollen lymph nodes in the armpits, neck, groin and chest
  • Joint pain
  • Development of kidney stones
  • Abnormal heartbeat (arrhythmias)

If the nervous system is affected, this condition may lead to hearing problems, psychiatric disorders or seizure. 

How is it diagnosed? 

Your doctor will examine your symptoms and take a medical history. If sarcoidosis is suspected, the following tools can be used to confirm diagnosis:

  • Chest X-ray to inspect for swollen lymph nodes or any pulmonary infiltrates that appear as ‘cloudy’ areas
  • A CT (computerised tomography) scan to provide a more detailed look at the lungs
  • Breathing or pulmonary function tests to measure lung capacity
  • A bronchoscopy to examine the bronchial tubes, and take a biopsy or tissue sample to rule out other conditions
  • Blood tests to check for liver and kidney function
  • An eye exam

What are your treatment options? 

Treatment involves managing symptoms, and preventing the condition from becoming chronic or affecting vital organs. It includes:

  • Corticosteroids: This anti-inflammatory medication is the first line of treatment for sarcoidosis. If necessary, they can be administered as an inhaler or as a skin cream when there is skin involvement.
  • Anti-rejection drugs: These suppress the immune system and reduce inflammation.
  • Anti-malaria medication: For nervous system involvement and high calcium levels in the blood, this medication can be helpful.
  • TNF-alpha (tumour necrosis factor) inhibitors: If the inflammation associated with sarcoidosis does not respond to other treatment, this medication may be considered – it is used to treat inflammation resulting from rheumatoid arthritis.
  • Surgery: This may be considered if there is severe damage to the liver or lungs. 

Can it be prevented? 

Sarcoidosis is something of a mystery disease in that its exact causes are not known. Some general measures, as well as being aware of the risk factors may help reduce the risk of contracting the condition.

Risk factors include:

  • Age and gender: Sarcoidosis occurs more frequently in women and between the ages of 20 and 40.
  • Family history: If someone in your family suffers from or suffered from sarcoidosis, there is an increased likelihood that you will get it too.

Quitting smoking, moderating alcohol consumption, and avoiding exposure to toxic fumes and gases may help reduce the risk. 

IMAGE CREDIT: 123rf.com

The accuracy of this information was checked and approved by physician Dr Thomas Blake in July 2016