Sarcoidosis is a disease that causes a small collection of cell growths (granulomas) that become inflamed in the body. The exact cause of sarcoidosis unknown but experts have a few speculations; one being the body’s own immune system responding to an unknown substance. Other research has suggested chemical exposures, dust, infectious agents, and perhaps the body’s own proteins forming the granulomas. This disease usually affects the following organs:
- Lungs
- Heart
- Eyes
- Skin
Symptoms of Sarcoidosis
Symptoms of sarcoidosis depend upon which body system is being affected by the disease. Sometimes the disease slowly develops and symptoms can last years, others have sarcoidosis and are unaware they have it because symptoms do not manifest.
General symptoms include fatigue, swollen lymph nodes, weight loss, and pain and swelling of joints like the wrists and ankles. The lungs are the most commonly affected organ for sarcoidosis, especially in veterans. Lung symptoms consist of shortness of breath, wheezing, chest pain, and a chronic dry cough. The skin can be affected by forming reddish-purple rash on the lower legs usually warm to touch, also lesions on the nose, cheeks, and ears; growths under the skin usually around scars or tattoos are also a possibility. Sarcoidosis of the eyes will cause blurred vision, eye pain, burning, itching, dry eyes, severe redness, and sensitivity to light. Symptoms affecting the heart will cause chest pain, shortness of breath, fainting, fatigue, irregular heartbeats, fluttering, and edema from a build-up of excess fluid. Those are the most heavily affected organ systems for people with sarcoidosis but it can flare up in any part of the body such as; nervous system, liver and spleen, muscles, bones and joints, kidneys, lymph nodes, and calcium metabolism.
Does a Cure for Sarcoidosis Exist?
Diagnosis is difficult because of the few signs in the early stages of sarcoidosis, and symptoms sometimes mimic other diseases. Your physician can do an overall physical exam to listen to your heart and lungs and also check the skin for rash and lesions, ordering routine blood work, as well as checking joints and lymph nodes for swelling. Diagnostic testing is also a determinant in a proper diagnosis. Chest X-Rays, MRIs, CT Scans can all check the status of the heart and lungs and identify for granulomas. Eye exams to address any visual difficulty or discomfort caused by sarcoidosis, pulmonary function test (PFT) measure the lung volume and amount of oxygen sent to the blood, and PET scan to see if the nervous system is affected.
There is no cure for sarcoidosis but there are treatment options to help with inflammation that it creates. Corticosteroids are often the first line of defense and are a strong anti-inflammatory and can also be prescribed as a cream or eye drops. Immune suppressants reduce inflammation by suppressing the immune system to control symptoms. Hydroxychloroquine may be prescribed to treat skin lesions and elevated blood-calcium levels. When the before mentioned treatment options do nothing to help the symptoms Tumor necrosis factor-alpha (TNF alpha) inhibitors help with inflammation as well. Once an organ system is greatly affected by sarcoidosis and is no longer functioning properly the possibility of the need for an organ transplant is a reality, although rare.
To live with sarcoidosis and go untreated can lead to secondary conditions, which would interrupt daily functioning and possibly cause death. Complications like permanent scarring of the lungs making it difficult to breathe and developing pulmonary hypertension. The inflammation that sarcoidosis creates can affect all parts in the eye untreated it could lead to blindness. Due to the fact that sarcoidosis interrupts how the body processes calcium it is very common to develop kidney stones which reduce kidney function and seldom leads to kidney failure. When granulomas form in the brain or spinal cord inflammation can affect the facial nerves causing facial paralysis. The biggest risk is the formation of granulomas in the heart which interrupts heart rhythm, function, and blood flow this may lead to death.
Incidence of Sarcoidosis in veterans
A link was formed between sarcoidosis and military service after a Navy deck grinder’s diagnosis was changed from sarcoidosis to dust-induced lung disease by the VA. This caused the Navy to ask
for the help of the National Institute for Occupational Safety and Health (NIOSH) to figure out if Navy work environments were connected to lung diseases and sarcoidosis.
Information was gathered for sarcoidosis incidence rate from 1943 through 1993, it was discovered that there was a significant increase of military sarcoidosis in the 1960s and 1970s. Also discovered was the fact that service members who worked on “clean ships” had a decreased chance of developing sarcoidosis.
This investigation found that sarcoidosis and similar lung diseases in the military could be associated with environmental factors. Since the diagnosis of sarcoidosis was found to be much higher in Vietnam Veterans, clinical studies have been underway to assess their military occupational and work environments in a more detailed manner. This is in hopes to gain a better understanding and identify preventable measures for future service members.
If you need assistance in appealing a claim for sarcoidosis due to your time in service please fill out our form or call our office.
