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Sarcoidosis: Chronic Sarcoidosis
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Sarcoidosis (SAR-coy-DOH-sis) is an inflammatory disease characterized by granulomas (small rounded outgrowths made up of blood vessels, cells and connective tissues) that can produce many different symptoms. It is generally a chronic disease, lasting for several years or a lifetime. Some people... may have a type that only lasts a few months.
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Depending on the severity, treatment may be needed to control what sarcoidosis does. Sarcoidosis can go dormant on its own or with treatment, and its symptoms often do not recur after the initial onset. In a small percentage of cases, sarcoidosis is chronic, requiring on-going treatment, with possible occurrence in other organ systems. Chronic sarcoidosis is apparently cyclic in its activity level, with flares of symptoms and more dormant periods lasting weeks or months. No markers have been identified as indicating how sarcoidosis is going to behave in any individual or how an individual with sarcoidosis is going to respond to treatment, although a physician experienced with sarcoidosis may be able to make a "good guess" based on his or her experience. Whether he or she is willing to voice that guess is another story entirely!
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Sinuses: Sarcoidosis can ... cause inflammation of the sinuses (called sinusitis). Symptoms include a runny nose, stuffiness, and sinus pain or headache. The sinusitis associated with sarcoidosis is often chronic and can be very troublesome, although it is rarely serious.
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The etiology of sarcoidosis is unknown, but several immune aberrations have been noted and are thought to play a role in its pathogenesis. Studies have shown an increase in B-cell activity with hypergammaglobulinemia noted in about one half of patients and in nonspecific immune-complex formation. Reduced delayed-type hypersensitivity responses are ... found in many patients with sarcoidosis. Cutaneous anergy to tuberculin intradermal testing occurs in two thirds of patients. Immune dysregulation has been theorized to be due to a persistent antigen of low virulence that is poorly cleared by the immune system, leading to a chronic T cell of the Th1 subtype response, which results in granuloma formation. Medications that increase the Th1 response, such as interferon, have been reported to trigger or exacerbate sarcoidosis.
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The range and severity of symptoms associated with sarcoidosis vary greatly, depending upon the specific organ(s) involved and the degree of such involvement. In some cases, the symptoms of sarcoidosis may begin suddenly (acute), sometimes severely, and subside in a relatively short period of time (self limited). Acute sarcoidosis is often characterized by fatigue, fever, generalized muscle aches, difficulty breathing (dyspnea), joint pain, swollen glands, skin eruptions, eye irregularities, and/or other symptoms. In the subacute form, affected individuals may experience no symptoms (asymptomatic), even with organ involvement. In the chronic form of sarcoidosis, symptoms may appear slowly and subtly, and may persist or recur over a long time span. Initial symptoms of the chronic form of the disorder may include difficulty breathing (dyspnea), dry cough, limited airflow, and other respiratory abnormalities. Symptoms associated with other organ involvement may follow.
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The course of sarcoidosis ... varies among individuals. Usually, patients who experience more generalized symptoms, such as weight loss and fatigue, develop a mild form of the disease. Patients suffering from shortness of breath and skin rashes may develop more chronic, severe sarcoidosis. Race also seems to play a role as well. Caucasians are more likely to develop a mild form of the disease, while African Americans tend to develop the more chronic, severe form.
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Chronic Sarcoidosis