Sarcoidosis treatment

At Mayo Clinic Healthcare in central London, our respiratory specialists and rheumatology consultants provide expert assessment and sarcoidosis treatment for those with symptoms or confirmed diagnosis.

Using advanced diagnostic imaging, lung function testing and a collaborative approach, our consultants assess how sarcoidosis is affecting you before recommending a personalised plan for care.

Sarcoidosis most often affects the lungs and lymph nodes, but it can involve several parts of the body. Because its symptoms can resemble those of other conditions, an accurate diagnosis and careful assessment of the organs involved are important before treatment begins.

Sarcoidosis is an inflammatory condition in which small clusters of immune cells, called granulomas, develop in one or more parts of the body.

The lungs and lymph nodes in the chest are affected most often, but sarcoidosis can also affect the skin, eyes, joints, heart, nervous system, and other organs.

For many people, sarcoidosis improves without specific treatment. In others, inflammation continues over time and may affect how well an organ works. Your treatment will therefore depend on your symptoms, the organs involved and the risk of lasting damage.

Sarcoidosis is not cancer and it is not contagious.
Sarcoidosis symptoms vary considerably from person to person. Some people have no noticeable symptoms and the condition is discovered during a chest X-ray or another investigation.

When symptoms do occur, they may include:

A persistent dry cough

Shortness of breath

Chest discomfort

Tiredness or reduced energy

Fever

Unexplained weight loss

Swollen lymph nodes

Painful or swollen joints

Red, painful or irritated eyes

Changes to the skin

Heart palpitations or an irregular heartbeat

What does a sarcoidosis rash look like?

A sarcoidosis rash can take several forms. Some people develop tender, raised areas, often on the shins. This is called erythema nodosum. The affected skin may look red, purple or darker than the surrounding skin depending on your skin tone.

Sarcoidosis can also cause persistent raised patches or bumps elsewhere on the body. One less common form, called lupus pernio, causes long-lasting purple or reddish-purple areas, usually around the nose, cheeks, ears or fingers.

Not every skin change in someone with sarcoidosis is caused by the condition. Your consultant may recommend a dermatology assessment or, in some cases, a skin biopsy if the diagnosis is uncertain.
Speak to a doctor if you develop persistent breathlessness, an unexplained cough, recurring skin changes or other symptoms that do not settle.

If you already have sarcoidosis, new symptoms can sometimes indicate involvement of another organ. Tell your care team promptly about symptoms such as:

New or worsening problems with your vision

Palpitations, dizziness or fainting

Significant or rapidly worsening breathlessness

New weakness, numbness or other neurological symptoms

Severe difficulty breathing, significant chest pain or loss of consciousness requires urgent medical attention.
The exact causes of sarcoidosis are not yet fully understood.

Research suggests that the condition develops when the immune system reacts strongly to a trigger in someone who is susceptible to the disease. Possible triggers under investigation include certain infections and environmental exposures, but no single cause has been identified.

Genetic factors also appear to influence susceptibility. Having a close relative with sarcoidosis may increase your likelihood of developing it, although sarcoidosis is not usually inherited in a simple or predictable way.

The condition can affect people from any background. Differences in risk and patterns of disease have been observed between ethnic groups and populations, but these do not determine whether an individual will develop sarcoidosis.
At Mayo Clinic Healthcare, your assessment starts with a detailed consultation with one of our respiratory consultants. Your consultant will ask about your symptoms, medical history, medicines, family history and any possible environmental or occupational exposures.

They will then recommend investigations according to your individual circumstances. There is no single test that diagnoses every case of sarcoidosis, so results usually need to be considered together.

Tests may include:

Chest X-ray — to look for enlarged lymph nodes, lung inflammation or other changes within the chest.

CT scan — to provide more detailed images of the lungs and lymph nodes when further assessment is needed.

Lung function tests — to measure how well your lungs move air and transfer oxygen into your bloodstream.

Blood tests — to assess your general health and look for effects on organs such as the kidneys or liver, as well as changes in calcium levels.

Electrocardiogram (ECG) — to check your heart rhythm, particularly if there is concern about cardiac involvement.

Eye assessment — which may be advised because sarcoidosis can sometimes affect the eyes.

Biopsy — a small sample of tissue may be examined under a microscope when tissue confirmation is needed.

If tissue sampling or another investigation that is not provided on site is necessary, your consultant can discuss the appropriate next step and coordinate further specialist care.

Sarcoidosis can resemble infections, inflammatory diseases and, occasionally, certain cancers. Your assessment is therefore designed not only to look for evidence of sarcoidosis but also to exclude other possible explanations for your symptoms.
Sarcoidosis treatment is tailored to the organs affected, the severity of your symptoms and the likelihood of long-term organ damage.

Not everyone needs medicine as part of their treatment. If your symptoms are mild and tests show that your organs are working well, your consultant may recommend regular monitoring rather than starting treatment immediately.

Monitoring may include repeat consultations, lung function tests, imaging or blood tests to check whether the condition is improving, remaining stable or becoming more active.

When active treatment is needed, options may include:

Corticosteroids, such as prednisolone, to reduce inflammation. These are often the first medicine considered when sarcoidosis is significantly affecting the lungs or another organ.

Steroid-sparing medicines, such as methotrexate, in selected people who need longer-term treatment, have persistent disease or develop troublesome steroid side effects.

Other immune-modifying treatments for more complex or treatment-resistant disease, depending on which organs are involved and how the condition responds.

Treatment directed at a particular organ, such as eye or skin treatments where appropriate.

Supportive care, including advice on physical activity, smoking cessation and management of symptoms or treatment side effects.

Your consultant will discuss the expected benefits and possible side effects of treatment with you. If you need corticosteroids or other medicines over a longer period, careful monitoring forms an important part of your care.
Although sarcoidosis commonly affects the lungs, it is a condition that can involve several body systems.

At Mayo Clinic Healthcare, your respiratory consultant can work with specialists in areas such as cardiology, neurology, rheumatology and diagnostic imaging when your symptoms suggest broader involvement.

This multidisciplinary approach is particularly valuable for complex sarcoidosis, where treatment decisions need to take account of more than one organ or medical condition.
Mayo Clinic Healthcare brings Mayo Clinic's internationally recognised model of collaborative care to central London.

For people with sarcoidosis, this includes:

Access to highly experienced respiratory consultants who assess both common and complex lung conditions

Advanced diagnostic imaging and respiratory testing

A personalised approach based on your symptoms, test results and individual priorities

Coordinated input from specialists across different medical disciplines when required

Access to Mayo Clinic's wider clinical expertise in the United States for complex cases where additional specialist input may be valuable

Convenient private care in central London for UK and international patients

Our aim is to give you a clear understanding of your condition and the options available to you, so that you can make informed decisions about your care.

Private health insurance

Mayo Clinic Healthcare works with all major private health insurance providers, including AXA PPP, Aviva, BUPA, Health Partners Group, Vitality Health and WPA. Self-pay arrangements are also available.

Private assessment

If you have symptoms of sarcoidosis, have recently received a diagnosis or would like another specialist opinion about your sarcoidosis treatment, our respiratory team can provide a detailed assessment and personalised recommendations.

Request an appointment with Mayo Clinic Healthcare or call +44 (0) 207 871 2575.

Medically Reviewed by

Dr Anna Nuttall, Consultant Rheumatologist