A multisystemic, granulomatous disorder, sarcoidosis characteristically produces lymphadenopathy, pulmonary infiltration, and skeletal, liver, eye, or skin lesions. It’s most common in young adults (ages 20 to 40). In the United States, sarcoidosis occurs predominantly among blacks and affects twice as many women as men.
Acute sarcoidosis usually resolves within 2 years. Chronic, progressive sarcoidosis is associated with pulmonary fibrosis and progressive pulmonary disability.
Although the cause of sarcoidosis is unknown, the following possible causes have been considered:
hypersensitivity response (possibly from a T-cell imbalance) to such agents as atypical mycobacteria, fungi, and pine pollen
genetic predisposition (suggested by a slightly higher incidence of sarcoidosis within the same family)
chemicals, such as zirconium or beryllium, can lead to illnesses resembling sarcoidosis, suggesting an extrinsic cause for this disease.
Signs and symptoms
Initial signs and symptoms of sarcoidosis include arthralgia (in the wrists, ankles, and elbows), fatigue, malaise, and weight loss. Other signs and symptoms vary according to the extent and location of fibrosis:
respiratory — breathlessness, cough (usually nonproductive), substernal pain (complications in advanced pulmonary disease include pulmonary hypertension and cor pulmonale)
cutaneous—erythema nodosum, subcutaneous skin nodules with maculopapular
eruptions, extensive nasal mucosal lesions
ophthalmic—anterior uveitis (common); glaucoma, blindness (rare)
lymphatic—bilateral hilar and right paratracheal lymphadenopathy and splenomegaly
musculoskeletal—muscle weakness, polyarthralgia, pain, punched-out lesions on phalanges
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