Many people with sarcoidosis only discover that they have the disease during a chest X-ray that is ordered for another reason. Other people may have minor symptoms that do not worsen. It is rare that sarcoidosis causes serious symptoms.
Sarcoidosis can cause calcium to collect in the blood and urine because the granulomas produce activated vitamin D, which causes the intestines to absorb more calcium. High blood calcium levels lead to a loss of appetite, nausea, vomiting, thirst and excessive urine production. After a long time, high blood calcium levels may lead to kidney stones or calcium deposits in the kidney and, eventually, to kidney failure.
The signs of sarcoidosis vary widely. They can include:
- Aching joints
- Chest pain
- Enlarged lymph nodes that usually do not cause symptoms
- Feeling tired
- Feeling unwell generally
- Fever and night sweats
- Losing weight
Sarcoidosis has different effects on different organs, such as the:
Eyes. In some people with sarcoidosis, parts of the inside of the eye become inflamed (swollen and tender), causing redness and difficulty seeing. If the inflammation continues for a long time, it may keep fluid from draining from the eye, causing glaucoma or eventual blindness. In some cases the granulomas may form in the membrane that covers the eyeball and the inside of the eyelids (the conjunctiva). Sometimes people with sarcoidosis have dry, sore and red eyes due to sluggish tear glands that are affected by the disease.
Joints. The swelling and tenderness can cause achy joints, especially in the hands and feet. Cysts that form in the bones can inflame nearby joints.
Liver. Almost three out of four people with sarcoidosis have it in the liver. These often produce no symptoms or apparent changes in how the liver functions
Nerves of the head. Sarcoidosis that affects the nerves of the head can cause double vision and make one side of the face droop. If the pituitary gland or the bones surrounding it are affected, diabetes insipidus may result. The pituitary gland stops producing vasopressin, a hormone needed by the kidneys to concentrate urine, causing frequent urination and excessive amounts of urine
Skin. Over a long period of time, sarcoidosis may cause flat patches, raised patches or lumps just under the skin along with discoloration of the nose, cheeks, lips and ears.
Causes and Risk Factors
The cause of sarcoidosis is not yet known. Some factors may be infections, an abnormal response of the immune system or genetics. It usually develops between the ages of 20 and 40. It is most common among Swedes and African American, although it can occur in anyone.