Symptoms

Symptoms vary and can occur in different parts of the body, depending on where the granulomas form. Most symptoms develop in the lungs, skin, eyes, and liver. Multiple body systems may be affected. Symptoms may come and go. This disease is often acute, but in some patients it is chronic, waxing and waning.

Symptoms may include:

• Cough
• Shortness of breath
• Wheezing
• Chest pain
• Rash (may or may not be raised)
• Fever
• Pain or irritation of eyes
• Fatigue, especially with exertion
• Muscle weakness
• Night sweats
• Loss of appetite
• Weight loss
• Swollen lymph nodes
• Seizures
• Tremors
• Difficulty hearing
• Blurred vision or blindness
• Poor coordination
• Trouble walking
• Irregular heart rate
• Pain, swelling, and stiffness in the joints
• Facial paralysis ( Bell’s palsy )

Bell's Palsy

© 2009 Nucleus Medical Art, Inc.

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. There is no specific lab test that confirms a diagnosis of sarcoidosis. Instead, the diagnosis is made by noting a cluster of symptoms and a number of medical tests that are usually positive in patients with this condition.

In some cases there may not be any symptoms. The disease may sometimes be suspected based on the appearance of a routine x-ray .

Tests may include:

• Blood tests—to check for a variety of factors:
  • A complete blood count to check for anemia
  • Liver function tests to check for liver abnormalities
  • Increased calcium levels, which can occur with sarcoidosis
  • Elevated levels of angiotensin-converting enzyme (ACE), which is often released by the granulomas
• Urine test—24-hour urine test to check for elevated levels of calcium in the urine
• X-rays—a test that uses radiation to take a picture of structures inside the body
• Biopsy —removal of a sample of the affected tissue for testing
• Electrocardiogram (ECG, EKG) —a test that records the electrical activity of the heart
• Pulmonary function tests (PFTs) —tests to determine how well you can breathe
• Bronchoscopy —the insertion of a lighted tube into the lungs to look at the tissue and obtain a sample for biopsy. The doctor may also do a bronchoalveolar lavage. This involves flushing the lungs with fluid and collecting the fluid for analysis.
• Gallium scan—the injection of radioactive material into the body. The material collects in areas with sarcoidosis. A machine later scans the body and identifies areas with higher concentrations of the injected material.
• CT scan —a type of x-ray that uses a computer to make pictures of the inside of the body
• Eye exam—done with a special lighted instrument that allows the doctor to look inside the eye