Pulmonary hypertension associated with sarcoidosis (SAPH)
SAPH is pulmonary hypertension associated with sarcoidosis. It is a serious complication and is associated with a poorer prognosis. Several interacting mechanisms may contribute, while current treatment strategies address systemic sarcoidosis and pulmonary hypertension separately. SAPH is thought to arise from complex interactions between sarcoid-related inflammation in the lung tissue and pulmonary blood vessels.
Possible mechanisms include hypoxia, pulmonary-artery vasculitis, sarcoid-related heart failure, fibrotic destruction of the pulmonary vasculature, granulomatous obstruction of pulmonary vessels, sarcoid-related liver disease and later portopulmonary hypertension.
What is high blood pressure?
High blood pressure (hypertension) occurs when pressure in the arteries remains at an unhealthy level. It depends on the amount of blood pumped through the vessels and the resistance encountered as the heart pumps. A diagnosis should not be based on a single measurement. Repeated readings above 140/90 mmHg require medical assessment. Severe hypertension may be associated with headache, shortness of breath, nosebleeds, dizziness, chest pain, facial flushing or blood in the urine.
The following research summary discusses immunopathogenesis and emerging biomarkers in sarcoidosis. Sarcoidosis is a multisystem granulomatous disease whose causes and course are still being studied. Genetic susceptibility, environmental exposure and dysregulated innate and adaptive immune responses may shape granuloma formation and different clinical phenotypes. Biomarkers combining clinical, radiological, laboratory, molecular and immune data may eventually help distinguish active inflammation from established scarring, but most are not ready for stand-alone routine diagnosis.
Clinical decisions must still be based on the complete clinical picture, examination, imaging and standard laboratory tests—not on one biomarker. Evidence is heterogeneous and results can vary by sample, laboratory method, organ involved and disease stage.
This information is educational and does not replace a medical examination or medical advice.
Source: Immunopathogenesis and emerging biomarkers in sarcoidosis. Autoimmunity Reviews. 2026;25(3):103993. DOI: 10.1016/j.autrev.2026.103993
