The goal of sarcoidosis treatment is not to cure it

Sarcoidosis is a condition in which groups of immune system cells form small,
red, inflamed lumps called granulomas. They can form in any organ, and
most commonly affect the lungs and the lymph nodes in the chest. Over time
sarcoidosis can cause permanent scarring of organs.

The immune system creates inflammation to defend against germs and illness. In
sarcoidosis the inflammation goes off track, and the cells form granulomas
instead. Studies suggest it may be triggered by infections and by
environmental substances such as insecticides and mould, with your genes
affecting how your immune system reacts to the trigger.

Who is more likely to have it

• Age, especially over 55
• Living or working near insecticides, mould or other inflammation-causing
  substances
• A close relative with sarcoidosis
• Certain medicines, such as some HIV medicines and monoclonal antibodies
• Being of African or Scandinavian descent
• Being female

Symptoms, which many people do not have

Many people with sarcoidosis have no symptoms, or feel unwell without
anything obvious. Where symptoms appear there are general ones and
organ-specific ones.

General: fatigue · weight loss · swollen lymph nodes · depression · fever ·
night sweats.

Lungs: wheezing · cough · shortness of breath · chest pain.

Elsewhere: an enlarged liver or spleen · jaundice (yellowing eyes or
skin) · nervous system problems — headache, dizziness, vision problems,
seizures, numbness or tingling · heart palpitations or arrhythmia · pain
and swelling in the joints · rashes and growths under the skin.

Löfgren's syndrome

Some people have this set of symptoms when sarcoidosis first develops, and
it usually goes away completely within 2 years:

• Swollen lymph nodes in the chest, neck, chin, armpits or groin
• Erythema nodosum — a rash of small itchy or painful bumps, most often on
  the head, neck or legs
• Blurred vision, eye pain or redness, light sensitivity, watery eyes
• Joint pain, stiffness or swelling
• Fever

Diagnosis

There is no single test, and the symptoms resemble many other conditions,
which makes it hard to diagnose. A provider will ask about medical history,
symptoms, lifestyle and other conditions, and examine you — temperature,
whether lymph nodes, spleen or liver are swollen, listening to the chest, and
looking for rashes or sores including on the scalp and lower legs.

Then tests: chest x-rays, a biopsy of skin, lymph nodes, lungs or
other affected organs, blood tests for blood counts, hormone levels and
kidney function, and other imaging. After a diagnosis, further tests show how
the disease is affecting the body.

Treatment, and what it is aiming at

There is no cure. The goal is **remission — you still have the condition,
but it does not cause you problems.** That is the stated aim, and it is worth
knowing because it reframes what success looks like.

**You may not need treatment at all, and sometimes the condition goes away on
its own.** Where treatment is needed, what you get depends on your symptoms,
which organs are affected, and how well those organs are working. Medicines
may lower inflammation, treat an overactive immune response, treat joint pain,
or treat skin problems.

Complications may need other medicines, surgery, oxygen therapy, pulmonary
rehabilitation, or an implanted pacemaker or defibrillator.

Whether or not you have symptoms, get regular follow-up care, make healthy
lifestyle changes, and contact your provider about any new symptom.

Untreated, or where treatment does not work, sarcoidosis can cause serious
complications: lung, heart, hormone, brain, nerve, muscle and kidney problems,
and severe organ damage.

Source: National Heart, Lung, and Blood Institute, via MedlinePlus.