Sarcoidosis

Sarcoidosis causes the immune system to form clumps of inflammatory cells called granulomas. Too many granulomas in one area of the body can cause a range of symptoms, including a rash, shortness of breath, a heart attack, and even organ failure. The cause of sarcoidosis is unknown.

Types of Sarcoidosis
Sarcoidosis most often affects the lungs. This is called pulmonary sarcoidosis. Severe pulmonary sarcoidosis can cause pulmonary fibrosis, pulmonary hypertension, bronchiectasis, aspergilloma, and other problems.

Other types of sarcoidosis include:

• Cutaneous sarcoidosis affects the skin and causes a rash with red, painful bumps called erythema nodosum.
• Cardiac sarcoidosis affects the heart and can cause arrhythmias, heart attacks, pericarditis, heart valve problems, heart failure, and more.
• Ocular sarcoidosis affects the eyes and can lead to vision problems, glaucoma, cataracts, and more.
• Neurosarcoidosis affects the nervous system and can cause headaches, facial paralysis, vision changes, weakness, and more.
• Renal sarcoidosis affects the kidneys and can cause kidney failure.
• Hepatic sarcoidosis affects the liver and can cause liver disease.

Sarcoidosis can be difficult to diagnose because symptoms can mimic other conditions. To pinpoint sarcoidosis, doctors will perform a thorough physical exam, review your medical history, consider your symptoms, and recommend one or more of the following tests.

Imaging Scans
CT, PET, and MRI imaging scans show your bones, organs, and body systems in precise detail and help doctors identify abnormalities.

System-Specific Tests
These tests measure how well certain organs are functioning. (For example, a pulmonary function test assesses lung volume and oxygen exchange. An electrocardiogram records the heart’s electrical activity. And an echocardiogram can help identify heart problems and pulmonary hypertension.)

Blood and Urine Tests
These tests measure chemicals, proteins, and other substances in your blood and urine to gauge your overall health as well as kidney and liver function.

Biopsy 
For some types of sarcoidosis, a small tissue sample may be removed and analyzed in a lab to see if it shows signs of disease. 

While there is no cure for sarcoidosis, it is treatable. Many people with this condition do not require treatment, but it’s important see your doctor regularly to catch problems early since this can help prevent organ damage and organ failure. People with more advanced sarcoidosis need more advanced care.

Medications

• Steroids are usually the first treatment doctors recommend. They reduce inflammation and slow granuloma formation. However, steroids can cause unpleasant side effects like weight gain, insomnia, and mood changes.
• Immunosuppressants can reduce symptoms by controlling your overactive immune system. 
• Other medications treat specific symptoms.

Advanced Therapies
End-stage sarcoidosis may be treated with advanced therapies for specific organs, for example, oxygen therapy, left ventricular assist devices (LVADs), and dialysis.

Organ Transplants
People with end-stage sarcoidosis that has caused organ failure may need an organ transplant. Lung, heart, and liver transplants are some of the most common. 

Recognized Sarcoidosis Clinic
Our designated weekly sarcoidosis clinics bring multiple specialists together so you can see more than one doctor on the same day or even during the same appointment, if needed. Our clinic is recognized by the World Association for Sarcoidosis and Other Granulomatosis Diseases (WASOG) and the Foundation for Sarcoidosis Research (FSR) -- one of the few recognized sarcoidosis clinics in the U.S. and one of only two in North Carolina. This means we follow evidence-based guidelines and best practices for sarcoidosis treatment.

Team Approach to Care
Because sarcoidosis can affect multiple organs and body systems, a team approach ensures you receive the best-possible care. Our team of sarcoidosis specialists from pulmonology, cardiology, dermatology, rheumatology, ophthalmology, and neurology work together to share knowledge and discuss complex cases. 

Virtual Video Visits Available
To save you time and effort, we offer video follow-up visits for people who live in certain areas and who don’t need in-person testing.

Full Range of Care, Including Top Transplant Programs
We provide care at all stages of sarcoidosis, from diagnosis to treatment and organ transplant for more advanced cases. Duke boasts some of the best transplant programs in the country and beyond. Wait times are consistently some of the shortest, and our survival rates are among the best in the United States. If you need an organ transplant, you can be confident that you will receive the best-possible care at Duke.

Advancing Sarcoidosis Care
Our doctors and providers are studying ways to improve sarcoidosis care. As a Duke patient, you may be able to participate in clinical trials investigating new drugs, testing new treatment strategies, or establishing best practices.