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Sarcoidosis — Internal Medicine Perspective

A multisystem granulomatous disease most often presenting with hilar lymphadenopathy and pulmonary involvement.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

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What is Sarcoidosis — Internal Medicine Perspective?

Sarcoidosis is a multisystem granulomatous disorder of unknown etiology, with thoracic involvement (lung parenchyma and bilateral hilar lymphadenopathy) in over 90% of cases.

Diagnosis is based on a compatible clinical and radiologic picture, evidence of non-caseating granulomas on biopsy, and exclusion of mimicking diseases (tuberculosis, fungal infection, lymphoma, berylliosis).

Disease course varies: many patients (Löfgren syndrome) have spontaneous remission within 1–2 years, while others develop chronic, fibrotic, or extrapulmonary disease requiring immunosuppression.

Symptoms

Persistent dry cough, dyspnea on exertion, chest discomfort
Constitutional symptoms: fatigue, weight loss, low-grade fever, night sweats
Erythema nodosum, lupus pernio, papular skin lesions
Anterior or posterior uveitis, dry eye, lacrimal gland enlargement
Cardiac involvement: arrhythmia, AV block, cardiomyopathy
Neurosarcoidosis: cranial neuropathy, aseptic meningitis, hypothalamic dysfunction
Hypercalcemia, hypercalciuria, nephrocalcinosis

Risk Factors

Age 20–60 years, peak in fourth decade
African American or Northern European ethnicity
Female sex (slightly increased risk)
Family history of sarcoidosis
Occupational/environmental exposures (silica, mold, metal dust, agricultural antigens)
Non-smokers (paradoxically more affected)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent cough or shortness of breath with hilar lymphadenopathy on imaging
  • Eye redness/blurred vision, persistent skin lesions, parotid enlargement
  • New conduction abnormality on ECG, syncope, or unexplained heart failure
  • Unexplained hypercalcemia or kidney stones
  • Cranial nerve palsy or neurologic symptoms with prior sarcoidosis

Treatment Methods

01
Observation in asymptomatic stage I/II disease with stable function
02
Systemic corticosteroids (prednisone 20–40 mg/day, tapered) — first-line for symptomatic or organ-threatening disease
03
Steroid-sparing agents: methotrexate, azathioprine, leflunomide, mycophenolate
04
Anti-TNF agents (infliximab, adalimumab) for refractory disease
05
Topical corticosteroids/biologics for cutaneous and ocular disease
06
Cardiac sarcoidosis: PET/MRI staging, immunosuppression, ICD if indicated
07
Vitamin D and calcium caution, regular pulmonary function tests, multidisciplinary follow-up

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.