What Are the Symptoms of Pulmonary Sarcoidosis?

Many people with sarcoidosis have no symptoms and may not know they have the disease. Sarcoidosis can affect many organs and cause different symptoms. Pulmonary sarcoidosis can reduce the amount of air the lungs can hold and cause lung stiffness.

Symptoms can be different for each person. They may include:

- shortness of breath, often worsening with activity;
- a persistent dry cough;
- chest pain;
- difficulty breathing.

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

- extreme fatigue;
- fever;
- eye inflammation and pain, burning, blurred vision or sensitivity to light;
- night sweats;
- joint and bone pain;
- skin rash, lumps or colour changes on the face, hands or lower legs;
- swollen lymph nodes;
- weight loss.

Many of these symptoms can also be caused by other health problems.

How Is Pulmonary Sarcoidosis Diagnosed?

Pulmonary function tests

These tests measure the lungs’ ability to move air in and out. They are often performed using specialised machines into which the person breathes.

Blood tests

These may be used to check carbon-dioxide and oxygen levels in the blood, assess liver and kidney function, and look for infections and other diseases.

Bronchoscopy

A long, thin, flexible tube (bronchoscope) with a light at the end is passed down the throat and into the lungs. This allows the healthcare professional to examine the bronchi, the main airways of the lungs. It helps assess and diagnose lung problems. Samples of lung tissue (biopsies) and lung washings (lavage) can be collected through the tube.

In addition to a complete medical history and physical examination, you may have tests such as:

Chest X-ray

This imaging test assesses the lungs and heart. A chest X-ray can show important information about the size, shape and position of the lungs, the large airways (bronchi) and the area in the middle of the chest that separates the lungs (the mediastinum).

CT scan

This imaging test uses X-rays and computer technology to create cross-sectional images of the body. CT shows detailed images of any part of the body, including the lungs. It is more detailed than ordinary X-rays and may be used to diagnose lung disease, monitor progression and assess response to treatment.

Bronchoalveolar lavage

Sterile saline is placed into the lungs through a bronchoscope and then suctioned out. The saline carries cells from the lower airways. These cells can be examined under a microscope for inflammation and infection. The test may help rule out certain causes.

Lung biopsy

A small piece of tissue, cells or fluid is removed from the lungs and examined under a microscope.

How Is Pulmonary Sarcoidosis Treated?

Treatment is generally used to control symptoms and improve the function of organs affected by the disease. Steroid medicines such as prednisone help reduce inflammation and are often taken by mouth. Other medicines, such as methotrexate, may also be used to help reduce steroid-related side effects. Medicines such as infliximab may be used when the disease does not respond to other treatments.

Sometimes treatment is not needed. Different treatments work better for different people, and more than one treatment may be used. Most medicines used to treat sarcoidosis suppress the immune system.