Non Lung Aspects of Sarcoidosis
Lymph nodes that occur out side of the lungs occur in about one-third of patients. The may occur in the neck, above the collar bone, under the arms or in the groin area. They are typically non-tender and rarely cause problems unless they are larger and near an organ or blood vessel.
Sarcoidosis of the heart
Early diagnosis of sarcoidosis of the heart is important because early treatment improves prognosis. Sarcoidosis of the heart may occur in 10% of patients. It can be associated with a fatal outcome and sudden death. An EKG test is helpful for the diagnosis of an abnormal rhythm, but an echocardiogram and a heart study using thallium-201 is generally needed to thoroughly evaluate the heart for exclusion of sarcoidosis of the heart.
Prednisone treatment is recommended for established, clinically significant, sarcoidosis of the heart. In very severe and unusual situations, heart transplantation has been utilized. Implantable cardioverter-defibrillator has been used in life-threatening abnormal heart rhythm.
Sarcoidosis of the eye
Eye lesions may occur in up to one-quarter of patients. In some situations, inflammation of the eye can have a rapid onset with blurred vision, sensitivity to light and excessive tears. Sometimes, the conjunctiva, which is the red part of the eyelid, can have small, pale yellow nodules.
Topical corticosteroid therapy may be utilized for some forms of eye inflammation. Prednisone tablets are recommended for granulomas that have affected certain parts of the eye such as the retina, the optic nerve, the lacrimal glands, eyelids or the eye muscles.
Sarcoidosis of the skin
About one-quarter of patients with sarcoidosis will have one or more of the skin manifestations. These range from raised tender nodules in the shins called erythema nodosum to plaques, patches and some scars. A dermatologist may diagnose sarcoidosis from a skin biopsy of an atypical skin lesion.
Monthly injections of corticosteroid can be used for treatment of small nodules. The lesions resolve on a temporary basis and on a permanent basis in some situations, but the treatment may or may not affect the long-term outcome. Large or disfiguring lesions may require prednisone treatment.
Sarcoidosis of the nervous system
It is rare, but sarcoidosis can effect any part of the nervous system. Sometimes, the nerve in the face can be affected resulting in weakening of the facial muscle.
Prednisone treatment at 40 mg to 80 mg per day is utilized for treatment of sarcoidosis involving the brain, large nerves from the brain or peripheral nerves. Long term effectiveness has not been fully established. In rare situations, certain types of surgical procedures may be utilized.
Sarcoidosis of the liver
Although there may be sarcoidosis granulomas in the liver in 40 to 70 percent of patients, significant liver dysfunction is rare.