Complications Of Sarcoidosis: Organ Damage, Eye Problems, And Skin Rashes

What is Sarcoidosis?

Sarcoidosis is an inflammatory disease that commonly presents with small lumps (granulomas) growing throughout the body; these granulomas are made of inflammatory cells and can occur anywhere in the body but commonly occur in the lungs, skin and lymph nodes. Granulomas can form in any tissue in the body and if they grow in certain organs, they can cause dysfunction and symptoms in that specific organ system.

Sarcoidosis can occur suddenly and present with symptoms, but in most people, these subside within a few months or years; with the condition never returning, this is called acute sarcoidosis.

Chronic sarcoidosis is a more gradual advancement of symptoms over time with more severe symptoms occurring and a greater impact on health.² 

Symptoms of Sarcoidosis

Due to the nature of sarcoidosis potentially affecting any tissue, some general symptoms can occur:

• Swollen lymph nodes (glands)
• Fatigue
• Weight Loss
• Pain or swelling in joints

There are more specific symptoms depending on the organs affected. Symptoms for affected lungs may include:

• Shortness of breath
• Persistent dry cough
• Chest pain (less common)

Long-term lung scarring can occur, reducing the lungs' functionality and affecting the ability to breathe.¹ 

The skin is also a commonly affected area and presents with the most visible symptoms of sarcoidosis, these include:

• Tender, reddish-purple patches/lumps (particularly on the lower legs)
• Disfiguring sores on the head and face
• Lighter or darker areas of skin
• Growths under the skin

These lesions/rashes (areas of itchy, discoloured skin) are a very common way in which sarcoidosis presents. this can cause a problem in diagnosis as the symptoms are the same as other conditions which affect the skin. If any of these symptoms are severe, it could lead to scarring or some form of disfigurement on the skin.⁵

These are the most common presentations of sarcoidosis and the organs that are affected, however, any other organ or tissue can be impacted causing differing symptoms on a case-by-case basis.

Complications of Sarcoidosis 

Due to sarcoidosis being able to affect any organ or tissue in the body; a build-up or extended growth of granulomas, can seriously affect the function of that body part. This can cause damage to the organ due to the granulomas disrupting its structure. Granulomas in the heart can cause:

• Chest pain
• Arrhythmia
• Fainting
• Palpitations

These can all be symptoms caused by sarcoidosis affecting the heart, the rhythm and flow of blood may be affected by the presence of granulomas and can sometimes cause pulmonary hypertension (high blood pressure in the lungs), having a greater impact on overall health.³

The eyes are another organ that sarcoidosis affects more than others. The presence of granulomas in the eyes can cause several symptoms:

• Blurred vision
• Red, itchy eyes
• Dry eyes
• Light sensitivity

 Sarcoidosis can cause potential blindness, damage to the retina, and in rare cases cataracts or glaucoma.⁴ 

Causes of Sarcoidosis

Sarcoidosis is caused by the formation of growths (granulomas) that are a collection of inflammatory cells that result from an overactive immune system, a build-up of granulomas that affects an organ's function.

There is no known exact cause of Sarcoidosis, with environmental triggers causing the initial immune reaction and certain people may have a genetic predisposition to developing sarcoidosis.⁶  

Diagnosing Sarcoidosis

Due to sarcoidosis potentially affecting any tissue, testing and diagnosing it will not be easy. As a test of lung function or imaging of the lungs if those are the symptoms being suffered, may simply show that the lungs are being impacted and sarcoidosis is a potential cause, not definite. Tests performed would most likely be a form of imaging if the cause is related to the lungs or heart. Chest X-rays are the most common form of imaging used to identify potential sarcoidosis, MRI (magnetic resonance imaging) or CT (computed tomography) scans may also be used.

Biopsies are a way to confirm a sarcoidosis diagnosis, a portion of affected tissue is removed and examined under a microscope for confirmation. Biopsies can be most easily and less invasively, done on the skin, eyes or lymph nodes, if required biopsies of lung or heart tissue can occur.⁷

Treating Sarcoidosis

In many cases of sarcoidosis, there is no need for any treatment, as the symptoms can often reduce and disappear with no intervention. The need for any treatment is mainly decided on the extent sarcoidosis, granulomas growth and the level of organ involvement.³ 

the most common form of treatment is corticosteroids (prednisone and cortisone), to reduce inflammation or immunosuppressants in attempt to stop the immune system from causing any damage or further inflammation.⁷ 

It is often the case that a doctor would rather avoid treatment; as sarcoidosis can subside on its own, wanting to avoid any potential complications from medication. Potential complications are:

• Osteoporosis (weakened bones)
• Weight gain
• Insomnia

These medications would also put you at a greater risk of contracting an infectious illness, due to the effect they have on the immune system.⁸ Though this is not currently widely used in treatment, the favoured method of treatment is no treatment, if possible.

Summary

Sarcoidosis is a disease that has no known cause, but typified by the formation of granulomas (growths made of a collection of inflammatory cells). These granulomas can occur in any part of the body, most commonly this is the lungs, lymph nodes and skin. The presence of these granulomas can disrupt the structure and function of an organ causing damage to the organ or other tissues, such as the eyes and potentially worsening the eyesight.

With there being no defined cause of sarcoidosis, there is no certain way to prevent it

Sarcoidosis generally subsides on its own in a few months to years hence no treatment is recommended generally. Treatment would only occur in those who begin to suffer more complex symptoms and in whom the risk of greater organ damage is increased. Treatment mainly involves the use of corticosteroids and Immunosuppressants to battle the inflammation in sarcoidosis.