A Clinical Presentation:
Sarcoidosis
Jeianti Amin
UCF NP Resident
What is Sarcoidosis?
It’s an inflammatory disease, where an
individual’s immune system overreacts,
forming granulomas (microscopic
clumps/clusters of inflammatory cells)
affecting almost any organ in the body.
 Affects people of all ages. In the U.S. it
affects African American more than
Caucasian, however can affect people of
Northern European decent (especially
Scandinavian).
 Higher rates among women rather than
men. Most common in adults age 20-40.
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People at Risk

People who have certain jobs also may be
at higher risk for Sarcoidosis.
– Health care workers
– Elementary and secondary school teachers
– People whose jobs expose them to agricultural
dust, insecticides, pesticides, or mold
– Suppliers of building materials, hardware, or
gardening materials
– Firefighters
– People who have a family history
Sarcoidosis Continues….
Cause is unknown (scientists believes
there is a genetic component and some
chemical/virus that triggers the immune
response, not yet proven).
 Not contagious.
 Commonly effects the lungs, lymph nodes,
skin, eyes and liver. Other organs
includes kidneys, heart, brain, nervous
system, salivary glands, sinus, muscle and
bones (can be multi-system).

Sarcoidosis Symptoms Continue…
Signs & symptoms depends on the
organs/body part effected. Many people
have no or mild symptoms, less than ½
population effected needs treatment
(varies on organs involvement).
 Non-specific symptoms includes weight
loss, night sweats, and malaise.
 When first diagnosed may develop
Lofgren’s syndrome: fever, enlarged
lymph nodes, arthritis, erythema nodosum
(a rash of red or reddish-purple bumps on
ankles).

Sarcoidosis Symptoms Continue…
Lungs: 90% affected, experience cough,
wheeze, SOB, or chest pain and breathing
problems.
 Lymph Nodes: 90% affected, enlarged
nodes including the spleen.
 Liver: 50-80% affected, enlarged liver
with abnormal liver enzymes, rarely lead
to cirrhosis
 Skin: 25% affected, painful or red, raised
bumps on the legs or arms (called
erythema nodosum), discoloration of the
nose, cheeks, lips and ears (called lupus
pernio) or small brownish and painless
skin patches.

Sarcoidosis Symptoms Continue…
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Eyes: 25% affected, common s/s includes
burning, itching, tearing, pain, red eye,
sensitivity to light (photophobia), dryness, seeing
black spots (called floaters) and blurred
vision. Chronic uveitis (inflammation of the
membranes or uvea of the eye) can lead to
glaucoma, cataracts and blindness.
Heart: 10-25% affected, causing the heart to
beat weakly resulting in shortness of breath and
swelling in the legs and palpitations.
Brain & Nervous System: 5-13% affected,
experiencing headaches, visual problems,
weakness or numbness of an arm or leg and
facial palsy, poor coordination, seizures, tremors,
problems walking.
Sarcoidosis Continue…
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Musculosketal:
33% affected with
arthritis all joints,
muscle weakness
Sinus: 5% affected,
symptoms include
sinusitis, hoarseness,
SOB.
Other
Organs: Rarely, the
gastrointestinal tract,
reproductive organs,
salivary glands and
the kidneys (kidney
stones) are affected.

Diagnostic Tests:
–
–
–
–
Physical Exam
Chest X-ray
Blood Test (ACE level)
Pulmonary Function
Test
– EKG, Holter monitor
– CT/MRI/PET
– Bronchoscopy Biopsy
Treatment
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Treatment is geared towards
severity or symptoms (usually
treat with lung, kidney, heart,
brain, nervous system, eyes
involvement).
Treatment plans depends on
how well patient respond to
medicine and severity.
No cure. Rarely fetal.
Death results from
complications with lungs,
heart, brain.
Follow healthy lifestyle (eat
healthy, exercise, quit
smoking).
Seek ongoing medical care for
pregnancy, emotional stress
(fear, anxiety, depression and
support groups).

Treatment geared:
– Reduce inflammation
– Reduce size of granulomas
– Prevent permanent
scarring of the lungs and
other organs
– Decrease symptoms
usually with
corticosteroids
(prednisone), NSAIDS,
Hydroxychloroquine (treat
skin, brain and high level
of calcium resulting from
Sarcoidosis) and
Methotrexate (treating
Sarcoidosis that affects
your lungs, eyes, skin, or
joints).
References
Foundation for Sarcoidosis Research,
2010. What is sarcoidosis. Retrieved
October 01, 2010 from
http://www.stopsarcoidosis.org/sarcoidosi
s/diseasefacts.htm
 National Heart, Lung, Blood Institute,
2009. Sarcoidosis. Retrieved October 01,
2010 from
http://www.nhlbi.nih.gov/health/dci/Disea
ses/sarc/sar_whatis.html
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Thank You!!