Quick version
Sarcoidosis is an inflammatory disease in which the immune system forms small collections of inflammatory cells, called granulomas. The disease can affect several different organs, but they most often occur in the lungs and lymph nodes in the chest.
The symptoms of sarcoidosis vary greatly; some people have no symptoms and are diagnosed after having a chest X-ray for another reason. While others experience symptoms that affect energy, everyday life and physical activity and therefore seek help.
Common symptoms of sarcoidosis
With sarcoidosis that occurs in the lungs, the symptoms can develop gradually. Common symptoms include:
- a persistent dry cough
- shortness of breath, especially with exertion
- pressure or discomfort in the chest
- sometimes wheezing or wheezing
- fatigue and decreased energy
- fever, night sweats or weight loss
- pain in muscles or joints
Fatigue is common in sarcoidosis and can sometimes be very pronounced, even when changes on X-rays or in tests are limited. The fatigue may feel disproportionate to the level of activity and is not always better with rest.
Sarcoidosis in other organs
Sarcoidosis can also affect other parts of the body. Some examples of these are symptoms of skin changes, eye irritation or vision problems, joint pain, palpitations and neurological symptoms. Such symptoms are less common but they are important to assess, as they may indicate an impact outside the lungs.
A particular illness is Löfgren's syndrome. It is a condition that often causes fever, tender reddish-purple lumps on the lower legs, known as erythema nodosum, and swollen or painful ankles. Enlarged lymph nodes in the chest are also common. Löfgren's syndrome often has a good prognosis.
Changes on chest X-ray
In sarcoidosis, chest X-ray or computed tomography may show enlarged lymph nodes or small nodular thickenings in the lung tissue, sometimes called nodular changes. Such findings may be due to granulomatous inflammation, but may also have other causes. X-rays therefore always need to be assessed together with symptoms, examination and other test results.
How is sarcoidosis diagnosed?
A diagnosis can be made after a comprehensive medical assessment. The investigation may include questions about symptoms, a medical examination, a chest X-ray or CT scan, a lung function test and blood tests.
In many cases, a tissue sample from, for example, the skin, lymph node or lung is also needed. The sample can show granulomas and helps healthcare professionals rule out other conditions, such as infections or diseases that can cause similar changes.
How long does sarcoidosis last?
For many, the condition resolves on its own within months to a few years, especially in the case of Löfgren's syndrome. In others, the disease lasts longer and can vary between periods of more and less activity.
It can also come in relapses, which can mean that cough, shortness of breath, fatigue, fever, skin problems or joint pain increase. Regular follow-up is important to monitor symptoms, lung function and possible effects on other organs.
How is sarcoidosis assessed and treated?
Sarcoidosis is not assessed with a single test value. Instead, the doctor considers which organs are affected, how active the inflammatory changes appear to be and how the disease affects your everyday functioning.
In the case of sarcoidosis in the lungs, symptoms, lung function, oxygenation and X-ray changes are assessed, among other things. Treatment is not always needed, but may be relevant in the event of pronounced symptoms, impaired lung function or effects on, for example, the eyes, heart or nervous system.
Prognosis and when you should seek care
Most people with sarcoidosis have a good prognosis. Serious illness is uncommon, but the risk of complications increases if there is severe or long-term lung involvement or if the heart or nervous system is affected.
It is important to seek medical attention promptly if you experience new or worsening shortness of breath, chest pain, fainting, severe palpitations, vision changes, or neurological symptoms such as weakness, numbness, or slurred speech.
You should contact your healthcare provider if you have a prolonged dry cough, unexplained shortness of breath, or fatigue that affects your daily life, especially if you also have a fever, weight loss, skin changes, or joint pain.
