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Sarcoidosis is a condition which can affect many parts of the body but most commonly the lymph glands or the lungs.  It may on occasions affect the skin, joints and most other organs of the body. The cause is unknown. It is currently thought that it is an inflammatory action, possibly triggered by a variety of agents in the environment, notably dusts, and certainly on very rare occasions beryllium, in people who have an immune system prone to certain types of immune reaction. 

It may present as an incidental finding on a chest x-ray carried out for other reasons and cause no symptoms at all.  Commonly it presents with red lumps on the shins (Erythema Nodosum) often associated with evidence of enlarged lymph glands on the chest x-ray.  This presentation tends to be fairly acute over a short period of time and usually goes away.  It may be associated with joint pains and fever at the time.  This particular manifestation is sometimes called “Lofgren’s syndrome”. 

There may be a more insidious or slow onset with breathlessness or skin rashes, visual disturbance, and again possibly joint pains.  Occasionally sarcoidosis can cause disturbances in the blood, notably raising the levels of calcium.  That may be a clue in the blood test to the diagnosis.

 Diagnosis depends upon the various organs affected, but the clues are often obtained from the history, chest x-rays and blood tests.  Often it is necessary to carry out a biopsy of an affected organ or tissue to confirm the diagnosis.

There is no known cure for sarcoidosis and indeed often no treatment is required because the disease is not causing any symptoms or  problems, and can burn itself out or resolve over a period of years and never return. If treatment is required sometimes simple symptomatic pain killers are appropriate but for more significant disease where there is ongoing inflammation and damage in important organs such as the lungs, steroids may be necessary.  These usually have to be given for a considerable period of time. In this case monitoring of the disease often with lung function testing is required.  In fact in about 1 in 10 people with sarcoidosis the condition will slowly deteriorate over time and it proves fatal in about 2 in 100.