Sarcoidosis: small clusters of inflammation, mostly in the lungs
Often discovered on a routine chest X-ray
Dr. Elise Fabre
Pulmonologist
In simple terms
Why granulomas form, how often it resolves alone, and when treatment is required.
What it is, in plain words
In sarcoidosis, the immune system forms tiny clumps of inflammatory cells called granulomas. They can appear in any organ but the lungs and their lymph nodes are involved in about nine out of ten cases. In many people the granulomas disappear on their own within two years; in others they persist and cause scarring.
Signs to look out for
- Dry cough, breathlessness on effort and chest discomfort
- Tiredness, fever, night sweats and weight loss
- Painful red lumps on the shins, called erythema nodosum, with ankle joint pain
- Blurred vision, red painful eyes from uveitis
- Skin plaques, enlarged lymph nodes, and rarely heart rhythm problems or facial nerve palsy
Why it happens
The trigger is unknown, probably an environmental exposure in genetically susceptible people. It typically starts between 20 and 40 and is more frequent and more severe in people of African descent.
How doctors confirm it
Chest imaging shows enlarged lymph nodes at the lung roots. Diagnosis is supported by lung function tests, raised calcium or ACE levels, and confirmed by biopsy showing non-caseating granulomas, after excluding tuberculosis and other causes. Everyone needs an eye examination, an ECG and calcium testing.
Treatments and solutions
- Observation alone for mild disease, which frequently remits spontaneously
- Corticosteroids when there is significant lung, eye, heart, neurological or kidney involvement, or high calcium
- Steroid-sparing drugs such as methotrexate or azathioprine for long-term control
- Anti-TNF biologics for refractory disease
- Treating complications: bone protection during steroid therapy, oxygen and rehabilitation in fibrotic disease
Living with it day to day
Keep follow-up appointments even if you feel well: lung function and eye checks detect silent progression, and cardiac involvement, though uncommon, is serious and treatable.
When to seek medical help
Seek prompt care for palpitations or fainting, sudden visual change, severe breathlessness, or confusion with excessive thirst suggesting high calcium.
This article explains general health information in simple language. It does not replace advice from your own doctor.
The words explained
Medical terms used above, in everyday language.
- Inflammation
- The body's reaction to injury or irritation: redness, swelling, heat or pain.
- Diagnosis
- The moment a doctor identifies which illness is causing your symptoms.
- Immune system
- Your body's defence team: cells that fight germs and repair damage.
- Cardiovascular
- Related to the heart and blood vessels.
- Genetic
- Passed down in your family through your genes.
When should you see a doctor?
- Your symptoms last more than a few weeks or keep coming back.
- They get worse quickly, or stop you doing everyday things.
- You notice sudden pain, breathing trouble, fainting or bleeding — seek urgent care.
- You already take medication and want to change anything about it.
This article explains general health information. It does not replace advice from your own doctor.
Frequently asked questions
- What is Sarcoidosis: small clusters of inflammation, mostly in the lungs?
- Why granulomas form, how often it resolves alone, and when treatment is required.
- What are the main symptoms or signs of Sarcoidosis: small clusters of inflammation, mostly in the lungs?
- Common signs vary from person to person. The article above lists the symptoms to watch for, how they progress, and when they need medical attention.
- When should you see a doctor for Sarcoidosis: small clusters of inflammation, mostly in the lungs?
- See a doctor if symptoms last more than a few weeks, get worse quickly, stop you doing everyday things, or if you notice sudden pain, breathing trouble, fainting or bleeding.
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