Sarcoidosis is a rare disease caused by inflammation. It usually occurs in the lungs and lymph nodes, but it can occur in almost any organ. Sarcoidosis in the lungs is called pulmonary sarcoidosis. It causes small lumps of inflammatory cells in the lungs. These lumps are called granulomas and can affect how the lungs work. Pulmonary sarcoidosis is treated with a combination of drugs and therapies. The goal of treatment is to reduce inflammation and prevent the disease from progressing.

What is pulmonary sarcoidosis?

Sarcoidosis is a rare disease caused by inflammation. It usually occurs in the lungs and lymph nodes, but it can occur in almost any organ. Sarcoidosis in the lungs is called pulmonary sarcoidosis. It causes small lumps of inflammatory cells in the lungs. These lumps are called granulomas and can affect how the lungs work. The granulomas generally heal and disappear on their own. But, if they don’t heal, the lung tissue can remain inflamed and become scarred and stiff. This is called pulmonary fibrosis. It changes the structure of the lungs and can affect your breathing. Bronchiectasis can also occur. This is when pockets form in the air tubes of the lung and become infected. But, these problems are not common.

What are the symptoms of pulmonary sarcoidosis?

Most people with sarcoidosis do not have symptoms and probably don’t know they have the disease. It can affect many organs, causing a variety of symptoms. Pulmonary sarcoidosis can reduce the amount of air the lungs can hold and cause lung stiffness.

The following are the most common symptoms of pulmonary sarcoidosis. However, each person may experience symptoms differently. Symptoms may include:

  • Shortness of breath, which often gets worse with activity
  • Dry cough that will not go away
  • Chest pain
  • Wheezing

Sarcoidosis can also cause symptoms not directly related to the lungs, such as:

  • Extreme tiredness
  • Fever
  • Inflammation of the eyes and pain, burning, blurred vision, and light sensitivity
  • Night sweats
  • Pain in the joints and bones
  • Skin rashes, lumps, and color changes on face, arms, or shins
  • Swollen lymph nodes
  • Weight loss

The symptoms of pulmonary sarcoidosis may look like other conditions or medical problems. Talk with your healthcare provider for a diagnosis.

How is pulmonary sarcoidosis diagnosed?

In addition to a complete medical history and physical exam, tests used may include:

Chest X-ray: A type of imaging test is used to assess the lungs and the heart. Chest X-rays may show important information about the lungs’ size, shape, and location, bronchi (large breathing tubes), and mediastinum (area in the middle of the chest separating the lungs).

CT scan: An imaging test that uses X-rays and computer technology to produce horizontal, or axial, images or slices of the body. A CT scan shows detailed images of any body part, including the lungs. CT scans are more detailed than regular X-rays. They can diagnose lung diseases, monitor disease progression, and evaluate response to treatment.

Pulmonary function tests: These tests help measure the lungs’ ability to move air in and out of the lungs. The tests are usually done with special machines into which the person must breathe.

Blood tests: These can be used to check the amount of carbon dioxide and oxygen in the blood, evaluate liver and kidney function and look for infection and other diseases.

Bronchoscopy: A long, thin, flexible tube with a light at the end is put down the throat and into the lungs. This lets the doctor view the bronchi, the main airways of the lungs. It is done to help evaluate and diagnose lung problems. Lung tissue samples (biopsies) and lung washings (lavage) that remove cells from the lungs can be done through the bronchoscope.

Bronchoalveolar lavage: This is a procedure in which a sterile saline solution is put into the lungs through a bronchoscope and then suctioned out. The saline carries out cells from the lower respiratory tract, which can be checked under a microscope to help identify inflammation and infection. It can help rule out certain causes.

Lung biopsy: A test in which a small piece of tissue, cells, or fluid from the lungs is taken out and checked under a microscope.

When other lung diseases have been eliminated, sarcoidosis is often identified.

Ongoing monitoring

How often you see your doctor can vary based on your symptoms and treatment. Seeing your doctor regularly is important ― even if you don’t need treatment.

Your doctor will monitor your symptoms, determine treatments’ effectiveness, and check for complications. Monitoring may include regular tests based on your condition. For example, you may have regular chest X-rays, lab and urine tests, EKGs, and exams of the lungs, eyes, skin, and any other organ involved.

How Is Sarcoidosis Treated?

After receiving the test results, a specialist will help you decide on a treatment plan. Many patients require no treatment but should be followed by a specialist regardless. The goal of treatment is remission, meaning that the condition is no longer causing any complications.

If you need treatment, specialists often use medications that turn down your immune system’s activity. Several different medications can be prescribed to treat sarcoidosis. Often starting a new medication can come with new side effects, which is why it is important to report any changes to a doctor and stay on top of your lab work.

Suppose your sarcoidosis of the lungs progresses to pulmonary fibrosis. In that case, your doctor may recommend additional treatments such as respiratory medications, oxygen therapy, pulmonary rehabilitation and, in severe enough cases, may consider you a candidate for lung transplant.

What to expect from your doctor

Be ready to answer questions your doctor may ask:

  • What types of symptoms are you experiencing? When did they start?
  • Do you know if anyone in your family has ever had sarcoidosis?
  • What types of medical conditions have you had in the past, or do you have now?
  • What medications or supplements do you take?
  • Have you ever been exposed to environmental toxins, such as in a manufacturing or farming job?

Your doctor will ask additional questions based on your responses, symptoms, and needs. Preparing and anticipating questions will help you make the most of your time with the doctor.

Conclusion

Pulmonary sarcoidosis is a serious and potentially life-threatening condition. Treatment for pulmonary sarcoidosis generally involves a combination of medications and lifestyle changes. Some people may also require surgery. Early diagnosis and treatment are essential for the best possible outcome. If you or someone you know has been diagnosed with pulmonary sarcoidosis, it is important to seek medical care from a specialist who can create a personalized treatment plan.

Pulmonologist in Flemington, New Jersey

Hunterdon Pulmonary & Sleep Associates is a group of specialists who provide comprehensive care for patients with lung and sleep disorders. Our team of board-certified pulmonary and critical care physicians, board-certified sleep medicine physicians, certified registered nurse anesthetists, and support staff works together to provide the highest quality of care for their patients. Contact us today!