Commonly the age of onset is 20-40 years of age, but it can present in children and the elderly. Usually sarcoidosis presents without symptoms but with an abnormal chest radiograph and a normal physical examination. Sarcoidosis may affect almost any organ of the body but lungs, skin, and eyes are the most frequently involved.
The diagnosis is made by obtaining biopsies of affected organs and by ruling out other granulomatous diseases for which a cause is known (e.g. tuberculosis and fungal diseases) and other diseases commonly causing lymph node enlargement (e.g. various neoplasms).
The disease usually regresses spontaneously within two years of initial presentation. Therapy with agents that decrease inflammation may be required initially in severe cases or in cases involving critical organs (e.g. eye, central nervous system, heart, lungs) or when high blood levels of calcium occur. In addition, a few cases progress and require therapy for several years.
Drug therapy usually requires medication that causes side effects that also need to be monitored carefully by a physician. Over 70% of all patients have regression of their disease within two years of initial onset whether treated medically or not. Some cases progress relentlessly, however, and require long term therapy.
See also Dr. Hoitsma's thesis regarding a new manifestation of sarcoidosis.
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