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Systemic Sarcoidosis

Multisystem granulomatous disease of unknown cause

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is Systemic Sarcoidosis?

Sarcoidosis is a granulomatous disease in which immune cells form clusters (granulomas) without infectious or foreign-body cause.

Estimated to affect 10–40 per 100,000 people; highest incidence among adults of African or Northern European ancestry.

Etiology is unknown but felt to involve an exaggerated immune response in genetically predisposed individuals to environmental antigens (mycobacterial, propionibacterial, mineral dusts).

Diagnosis combines compatible clinical/radiographic picture, biopsy showing non-caseating granulomas, and exclusion of other causes (notably tuberculosis).

Course is highly variable: many patients remit spontaneously, others develop chronic progressive multi-organ disease.

Symptoms

Persistent dry cough, dyspnea on exertion, chest discomfort
Bilateral hilar lymphadenopathy on chest imaging
Erythema nodosum, lupus pernio, papules and plaques on the skin
Anterior uveitis, posterior uveitis, optic neuritis, dry eyes
Heart block, ventricular arrhythmias, cardiomyopathy from cardiac involvement
Cranial neuropathies (especially facial nerve), aseptic meningitis, neurosarcoidosis
Hypercalcemia, hypercalciuria, kidney stones
Fatigue, fever, night sweats, weight loss, polyarthralgia

Risk Factors

Age 20–60 years, with peaks in third and fifth decades
African American, Scandinavian or Northern European descent
Female sex (slight predominance)
Family history of sarcoidosis
Occupational exposure (firefighters, agricultural dust, metalworking fluids)

When to See a Doctor?

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

  • Persistent cough and dyspnea with abnormal chest imaging
  • Skin lesions with systemic symptoms (fever, joint pain, eye redness)
  • New onset palpitations, syncope or heart block
  • Visual changes, chronic eye redness or photophobia
  • Unexplained facial weakness, neuropathy or seizures

Treatment Methods

01
Watchful waiting in mild asymptomatic disease — many patients remit without therapy
02
First-line treatment when needed: oral corticosteroids (prednisolone 20–40 mg/day) tapered over 6–12 months
03
Steroid-sparing agents: methotrexate, azathioprine, mycophenolate mofetil for chronic disease
04
TNF-α inhibitors (infliximab, adalimumab) for refractory or severe organ involvement
05
Cardiac sarcoidosis: combined immunosuppression, ICD for arrhythmia risk, advanced heart failure care
06
Neurosarcoidosis: high-dose corticosteroids combined with disease-modifying agents
07
Annual screening for cardiac, ocular and renal involvement; vitamin D and calcium monitoring

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.