Kendall Ficklin, Founder of MenXchange and Author of Rise and Grind opens up about his battle with Sarcoidosis.
Sarcoidosis is is a disease that results from a specific type of inflammation of tissues of the body. It can appear in almost any body organ, but it starts most often in the lungs or lymph nodes.
The cause of sarcoidosis is unknown. The disease can appear suddenly and disappear. Or it can develop gradually and go on to produce symptoms that come and go, sometimes for a lifetime.
As sarcoidosis progresses, microscopic lumps of a specific form of inflammation, called granulomas, appear in the affected tissues. In the majority of cases, these granulomas clear up, either with or without treatment. In the few cases where the granulomas do not heal and disappear, the tissues tend to remain inflamed and become scarred (fibrotic). of sarcoidosis is unknown. The disease can appear suddenly and disappear. Or it can develop gradually and go on to produce symptoms that come and go, sometimes for a lifetime.
What are symptoms of sarcoidosis?
Shortness of breath (dyspnea) and acough that won’t go away can be among the first symptoms of sarcoidosis. But sarcoidosis can also show up suddenly with the appearance of skin rashes. Red bumps (erythema nodosum) on the face, arms, or shins and inflammation of the eyes are also common symptoms.
It is not unusual, however, for sarcoidosis symptoms to be more general. Weight loss, fatigue, night sweats, fever, or just an overall feeling of ill health can also be clues to the disease.
Who gets sarcoidosis?
Sarcoidosis was once considered a rare disease. We now know that it is a commonchronic illness that appears all over the world. Indeed, it is the most common of the scarring lung disorders and occurs often enough in the United States for Congress to have declared a national Sarcoidosis Awareness Day in 1990.
Anyone can get sarcoidosis. It occurs in all races and in both sexes. Nevertheless, the risk is greater if you are a young black adult, especially a black woman, or of Scandinavian, German, Irish, or Puerto Rican origin. No one knows why.
Because sarcoidosis can escape diagnosis or be mistaken for several other diseases, we can only guess at how many people are affected. The best estimate today is that about five in 100,000 white people in the United States have sarcoidosis. Among black people, it occurs more frequently, in probably 40 out of 100,000 people. Overall, there appear to be 20 cases per 100,000 in cities on the East Coast and somewhat fewer in rural locations. Some scientists, however, believe that these figures greatly underestimated the percentage of the U.S. population with sarcoidosis.
What are some signs and symptoms that suggest possible sarcoidosis?
In addition to the lungs and lymph nodes, the body organs more likely than others to be affected by sarcoidosis are the liver, skin, heart, nervous system, and kidneys, in that order of frequency. Patients can have symptoms related to the specific organ affected, they can have only general symptoms, or they can be without any symptoms whatsoever. Symptoms also can vary according to how long the illness has been under way, where the granulomas are forming, how much tissue has become affected, and whether the granulomatous process is still active.
Even when there are no symptoms, a doctor can sometimes detect signs of sarcoidosis during a routine examination, usually a chest x- ray, or when checking out another complaint. The patient’s age and race or ethnic group can raise an additional red flag that a sign or symptom of illness could be related to sarcoidosis. Enlargement of the salivary or tear glands and cystsin bone tissue are also among sarcoidosis signals.
The lungs are usually the first site involved in sarcoidosis. Indeed, about nine out of 10 sarcoidosis patients have some type of lung problem, with nearly one-third of these patients showing some respiratory symptoms—usually coughing, either dry or with phlegm, and dyspnea. Occasionally, patients have chest pain and a feeling of tightness in the chest.
It is thought that sarcoidosis of the lungs begins with inflammation of the alveoli (alveolitis), the tiny sac-like air spaces in the lungs where carbon dioxide and oxygen are exchanged. Alveolitis either clears up spontaneously or leads to granuloma formation. Eventually fibrosis can form, causing the lung to stiffen and making breathing even more difficult.
Eye disease occurs in about 20%-30% of patients with sarcoidosis, particularly in children who get the disease. Almost any part of the eye can be affected—the membranes of the eyelids, cornea, outer coat of the eyeball (sclera), retina, and lens. The eye involvement can start with no symptoms at all or with reddening or watery eyes. In a few cases, cataracts,glaucoma, and blindness can result.
The skin is affected in about 20% of sarcoidosis patients. Skin sarcoidosis is usually marked by small, raised patches on the face. Occasionally, the patches are purplish in color and larger. Patches can also appear on limbs, face, and buttocks.
Other symptoms include erythema nodosum, mostly on the legs and often accompanied by arthritis in the ankles, elbows, wrists, and hands. Erythema nodosum usually goes away, but other skin problems can persist.
Occasionally (1%-5%), sarcoidosis can lead to nervous system problems. For example, sarcoid granulomas can appear in the brain, spinal cord, and facial and optic nerves. Facial paralysis and other symptoms of nerve damage call for prompt treatment with medications such as high doses ofcortisone (see below). Also, people with sarcoidosis can have depressionthat is unrelated to the activity of the disease and is felt to be, in part, because of a misdirected immune system.
Symptoms can appear suddenly and then disappear. Sometimes, however, they can continue over a lifetime.
Sarcoidosis mainly affects people between 20 to 40 years of age. White women are just as likely as white men to get sarcoidosis, but the black female gets sarcoidosis two times as often as the black male. No one knows what causes sarcoidosis.