Sarcoidosis is a disease characterized by tissue changes that have a characteristic appearance under a microscope. Doctors think that it is caused by infection, but until recently, they were not able to find a cause and therefore, they did not have an effective treatment.
Over the years, doctors have found inconsistent evidence of atypical tuberculosis bacteria, but recently a test called PCR has found Mycobacterium tuberculosis in old sarcoid lesions (1,2). Also a recent article in the British Medical Journal, Lancet, shows that doctors have isolated Human Herpes Virus Type 8 (HHS-8) from sarcoidosis (3). It's too early to know whether drugs to treat these bacteria and viruses will cure sarcoidosis, but conventional TB drugs or ganciclovir may be found to cure sarcoidosis.
Sarcoid in your lungs usually starts as a cough or shortness of breath and your doctor sees lumps on your X-ray. Sarcoid can form a red rash or bumps in your skin. It can start out as weight loss, fatigue, night sweats or fever. More than 70% of those who develop sarcoidosis will get better with no treatment whatever. 20% can suffer permanent lung damage and remain short of breath. The disease will become chronic and require treatment in around 10 to 15%. 5-10% of people with sarcoidosis can suffer serious permanent damage to their brains, kidneys, liver, lungs or heart. Doctors often diagnose sarcoidosis when they see characteristic granulomas on tissue removed from the body. Most patients with sarcoidosis require no treatment. When the disease affects a person's health, doctors often prescribe cortisone-type drugs to reduce swelling. If sarcoidosis is associated with high blood calcium levels, the patient should avoid sunlight, vitamin D and calcium-rich foods. If cortisone-type drugs do not control the disease, doctors prescribe drugs, such as methotrexate or azathioprine to suppress immunity, but they are often ineffectual in controlling the disease.
1) J Mcfadden, J Colston. Crohn's disease, sarcoidosis and rheumatoid arthritis: Evidence for mycobacterial aetiology. Baillieres Clinical Infectious Diseases 4: 2(JUL 1997):119-129. Address J Mcfadden, Univ Surrey, Sch Biol Sci, Guildford GU2 5XH, Surrey, England.
2) The results confirm that the organisms are mycobacterial in origin and are similar, if not identical, to M tuberculosis. Their role in the pathogenesis of sarcoidosis is unknown. OM Kon, RM Dubois. Mycobacteria and sarcoidosis. Thorax 52: Suppl. 3 (AUG 1997):S47-S51.
3) Lancet 1997;350(9091):1655-61.
4) Good summaries about this disease can be obtained by writing the American Lung Association 1740 Broadway NY, NY 10019-4374 (212-315-8700) or National Institutes of Allergy and Infectious Diseases. 9000 Rockville Pike. Building 31, 7A32. Bethesda, Maryland 20892 or Sarcoidosis Family Aid and Research Foundation. 460A Central Avenue. East Orange, NJ 07018.
5) G Rizzato, A Riboldi, B Imbimbo, A Torresin, S Milani. The long-term efficacy and safety of two different corticosteroids in chronic sarcoidosis. Respiratory Medicine 91: 8 (SEP 1997):449-460.
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