In symptomatic patients, sarcoidosis can involve one or more body systems and present with a wide variety of signs and symptoms which can be constitutional; fatigue, weight loss, fever and malaise; generalized; or focused on a single organ. The onset of the disease is usually insidious but can be acute.
Respiratory symptoms are most common and include cough, chest discomfort, and dyspnea. Other symptoms and signs reflect the specific organs involved by the granulomatous disease. After the thorax, the lymph nodes, skin and the eye are most often involved. Other organs much less often produce signs and symptoms despite the fact that there are granulomas on histologic examination in many organs in the majority of patients.
Peripheral lymphadenopathy is common. The majority of patients have palpable non-tender lymph nodes.
There is thoracic lymphadenopathy in the large majority of patients. These enlarged lymph nodes seldom cause symptoms, but rare cases of venous obstruction including the superior vena caval syndrome and bronchial obstruction producing ateletasis have been reported. Thoracic lymphadenopathy is presented in the IMAGING section.
The organs affected by sarcoidosis are listed roughly in their order of frequency and then considered individually.
OTHER ORGANS INVOLVED BY SARCOIDOSIS
About one-third of patients have a dry cough and shortness of breath. There may be rales. Hemoptysis is rare. These signs and symptoms usually clear completely.
In the 20% of patients who are left with Stage IV disease there is irreversable parenchymal lung disease. Signs, symptoms, and pulmonary function studies in these patients can range from mild abnormality with few or no symptoms to fibrosis, emphysema, and bronchiectasis causing respiratory failure and death. Parenchymal abnormalities of the lung are presented in the IMAGING section.
|Terrence C. Demos, M.D.||
Last Updated: March 14, 1996
Created: March 1, 1996