Diagnosis

Sarcoidosis can be difficult to diagnose because the disease produces few signs and symptoms in its early stages. When symptoms do occur, they may mimic those of other disorders.

Your doctor will likely start with a physical exam, including a close examination of any skin lesions you have. He or she will also listen carefully to your heart and lungs and check your lymph nodes for swelling.

Diagnostic tests can help exclude other disorders and determine what body systems may be affected by sarcoidosis. Your doctor may recommend the following tests:

  • Chest X-ray to check for lung damage or enlarged lymph nodes
  • Computerized tomography (CT scan) if complications are suspected.
  • Positron emission tomography (PET) scan or magnetic resonance imaging (MRI) if sarcoidosis seems to be affecting your heart or central nervous system.
  • Blood tests to assess your overall health and how well your kidneys and liver are functioning.
  • Lung (pulmonary) function tests to measure lung volume and how much oxygen your lungs deliver to your blood.
  • Eye exam to check for vision problems that may be caused by sarcoidosis.

Biopsies

Your doctor may order a small sample of tissue (biopsy) be taken from a part of your body believed to be affected by sarcoidosis to look for the granulomas commonly seen with the condition. Biopsies can most easily be taken from your skin if you have skin lesions. Biopsies can also be taken from the lungs and lymph nodes if needed.

Treatment

There's no cure for sarcoidosis, but in half of cases it goes away on its own. You may not even need treatment if you don't have significant signs and symptoms of the condition, but you should be monitored with regular chest X-rays and exams of the eyes, skin and any other organ involved.

Medications

If your symptoms are severe or organ function is threatened, you will likely be treated with medication.

  • Corticosteroids. These powerful anti-inflammatory drugs are usually the first-line treatment for sarcoidosis. In some cases, corticosteroids can be applied directly to an affected area — via a cream to a skin lesion or drops to the eyes.
  • Medications that suppress the immune system. Medications like methotrexate (Trexall) and azathioprine (Azasan, Imuran) reduce inflammation by suppressing the immune system.
  • Hydroxychloroquine. Hydroxychloroquine (Plaquenil) may be helpful for skin disease and elevated blood-calcium levels.
  • Tumor necrosis factor-alpha (TNF-alpha) inhibitors. These medications are commonly used to treat the inflammation associated with rheumatoid arthritis. They can also be helpful in treating sarcoidosis that hasn't responded to other treatments.

Surgery

Organ transplant may be considered if sarcoidosis has severely damaged your lungs, heart or liver.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

Coping and support

Although sarcoidosis usually goes away by itself within two years, some people's lives are forever altered by the disease. If you're having trouble coping, consider talking with a counselor. Participating in a sarcoidosis support group may also be helpful.

Preparing for your appointment

Because sarcoidosis normally involves the lungs, you may be referred to a lung specialist (pulmonologist) to manage your care.

What you can do

Here's some information to help you get ready for your appointment and know what to expect from your doctor:

  • Write down your symptoms, including when they started and how they may have changed or worsened over time.
  • Take a list of all your medications, vitamins or supplements.
  • Write down your key medical information, including other diagnosed conditions.
  • Write down questions to ask your doctor.

What to expect from your doctor

Be ready to answer questions your doctor may ask:

  • What types of symptoms are you experiencing? When did they start?
  • Have you ever been exposed to environmental toxins, perhaps in a manufacturing or farming job?
  • Do you know if anyone in your family has ever had sarcoidosis?
  • What types of medical conditions have you had in the past?
  • What types of medications or supplements do you take?
March 16, 2017
References
  1. Ferri FF. Sarcoidosis. In: Ferri's Clinical Advisor 2016. Philadelphia, Pa.: Mosby Elsevier; 2016. https://www.clinicalkey.com. Accessed Aug. 28, 2015.
  2. Goldman L, et al., eds. Sarcoidosis. In: Goldman-Cecil Medicine. 25th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. http://www.clinicalkey.com. Accessed Aug. 28, 2015.
  3. Baughman RP, et al. A concise review of pulmonary sarcoidosis. American Journal of Respiratory and Clinical Care Medicine. 2011;183:573.
  4. AskMayoExpert. Sarcoidosis. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.
  5. O'Regan A, et al. Sarcoidosis. Annals of Internal Medicine. 2012;156:ICT5.
  6. Morgenthau AS, et al. Recent advances in sarcoidosis. Chest. 2011;139:174.
  7. Sanchez M, et al. Sarcoidosis. Dermatologic Clinics. 2015;33:389.
  8. Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG). American Journal of Respiratory and Critical Care Medicine.1999;160:736.
  9. Sah BP, et al. Novel pharmacotherapy of sarcoidosis. Pharmacology & Therapeutics. In press. Accessed Nov. 5, 2015.
  10. Barbara Woodward Lips Patient Education Center. Sarcoidosis. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.
  11. AskMayoExpert. Carciac sarcoidosis. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.