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Pulmonary sarcoidosis causes inflammation and granulomas in the lungs, and is the most common form of sarcoidosis. Symptoms include shortness of breath, coughing, and fatigue. Treatment involves medication and respiratory support, and follow-up with a specialist is necessary. The cause of sarcoidosis is unknown.
Pulmonary sarcoidosis is sarcoidosis that affects the lungs, or more specifically, the disease that creates inflammation that causes lumps or granulomas to form in the lungs. These granulomas may heal on their own or respond to treatment, but sometimes they cause lung damage, requiring additional treatment or management. Pulmonary sarcoidosis makes up 9 out of 10 cases of sarcoidosis. In most of these, pulmonary sarcoidosis is not fatal but is likely to require lifelong management. This can be difficult as the initial onset of the disease can occur as early as the 20s.
The causes of all forms of sarcoidosis are still a matter of controversy and it is suggested that they may be multiple. It certainly seems to appear more often in European Caucasians and African Americans. There are suggested genetic links and theories that specific genes can be activated by exposure to substances, viruses or bacteria. At present, there is no single clear cause.
When people have pulmonary sarcoidosis, the symptoms may not seem particularly noticeable or even bothersome at first. Granulomas in the lungs can cause shortness of breath, wheezing and a cough that does not respond to treatment. With this there may also be evidence of granulomas in the eyes, general tiredness, various forms of rashes and the presence of fever. Taken all together, these symptoms could suggest pulmonary sarcoidosis.
Doctors then confirm this with a variety of scans that could visualize any inflammation in the lungs or other parts of the body. The condition is not initially confirmed as pulmonary sarcoidosis. Evidence that granulomas do not form elsewhere, such as in other organs, is usually gathered before giving a specific diagnosis.
The goal of treatment then becomes to compensate for any potential injury that may occur due to ongoing inflammation. In most cases this means that people will be taking medications such as corticosteroids. There are other medicines, such as methotrexate, that could be used instead, but most people would start treatment with corticosteroids, only switching to other medicines if deemed medically necessary. Respiratory supportive drugs may also be used and may include those used in the treatment of chronic obstructive pulmonary disease.
In most cases, people with pulmonary sarcoidosis will need to continue follow up by a specialist. The frequency of visits could depend on the severity of the disease and the ability of the drugs to deal with it. In rare circumstances, more than medicine may be used. In rare cases, if lung damage from pulmonary sarcoidosis is severe, doctors may consider lung transplantation to address the problem.
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