What's sarcoidosis?
Sarcoidosis is a systemic granulomatous disorder of unknown cause. It most commonly affects the lungs but can involve many organs. Its hallmark on biopsy is small clusters of immune cells called non-caseating granulomas. Because no single cause or definitive test exists, it is largely a diagnosis of exclusion, made after ruling out look-alike conditions such as infection and lymphoma.
| Also indexed as | ORPHA:797, MONDO:0019338 |
|---|---|
| Features mapped | 19 |
| Treatments mapped | 4 |
| Published sources | 11 |
| Last reviewed | 2026-08-04 |
Signs and symptoms
Weight loss
Unintended weight loss can occur in sarcoidosis as part of the body's response to ongoing inflammation, and sometimes because the disease affects organs involved in digestion. New or ongoing weight loss is worth reporting because it can signal more active disease.
Ventricular tachycardia
when sarcoidosis affects the heart, ventricular tachycardia (a fast, abnormal rhythm starting in the lower chambers of the heart) is one of the recognised complications.
Lymphadenopathy
Swollen lymph nodes, classically the lymph nodes in the center of the chest (bilateral hilar lymphadenopathy), are a common finding.
Heart block
when sarcoidosis affects the heart it can disrupt the heart's electrical signals, and high-degree atrioventricular block (a slowing or blocking of the signal between the upper and lower chambers) is one of the recognised complications.
Pulmonary fibrosis
In a subset of people the lung disease advances to scarring (pulmonary fibrosis), which can reduce lung function and, in some, lead to pulmonary hypertension.
Cough
A persistent dry cough is one of the most common symptoms of sarcoidosis, because the disease most often forms inflammatory clumps of cells (granulomas) in the lungs. In case series it is reported by roughly half of patients.
Dyspnea
Shortness of breath (dyspnea) is a frequent symptom of sarcoidosis and usually reflects granulomas and, over time, scarring in the lungs. It often shows up with activity before it is noticeable at rest.
Diabetes insipidus
when sarcoidosis affects the hypothalamic-pituitary axis (the brain's hormone-control centre), it can cause diabetes insipidus, a problem with regulating body water that leads to heavy urination and thirst.
Chest pain
chest pain can be one of the symptoms of pulmonary sarcoidosis, along with cough and shortness of breath.
Fatigue
Fatigue is one of the most common and disabling symptoms of sarcoidosis, and it can persist even when the rest of the disease looks stable. It is not a sign of laziness or poor effort; it is part of the illness itself.
Skin plaque
when sarcoidosis affects the skin it most commonly appears as pink-red to red-brown raised bumps and plaques (flat, thickened patches), often on the head and neck.
Uveitis
Eye inflammation (uveitis) is a recognized feature and can occur alongside lung involvement and skin findings.
Erythema nodosum
Tender red bumps on the shins (erythema nodosum) can appear, especially in an acute form called Löfgren's syndrome, which often has a good outlook.
Fever
Some people with sarcoidosis have bouts of fever, often alongside joint pain. Fever can be part of the body's inflammatory response and is a common feature of the acute form known as Löfgren syndrome.
Hypercalcemia
Sarcoidosis can raise the level of calcium in the blood (hypercalcemia) because the granulomas make extra active vitamin D, which pushes the body to absorb more calcium. High calcium can cause thirst, frequent urination, and kidney problems if it is not managed.
Nephrocalcinosis
in sarcoidosis, a high blood calcium level that persists can lead to nephrocalcinosis (a build-up of calcium deposits in the kidneys).
Kidney stone
in sarcoidosis, a high blood calcium level that persists can lead to kidney stones.
Renal insufficiency
sarcoidosis can involve the kidneys, and a high blood calcium level can lead to acute kidney injury (a sudden drop in how well the kidneys filter) by narrowing the small arteries that supply them.
Arthritis
Joint pain or inflammation (arthralgia or arthritis), often in the ankles, can occur, particularly in the acute Löfgren's pattern.
How it is diagnosed
Sarcoidosis
Diagnosed using: serum angiotensin-converting enzyme level.
“No sensitive or specific biomarkers for diagnosis and prognosis exist, but there are several that can be used to support clinical decisions, such as serum angiotensin-converting enzyme levels, human leukocyte antigen types, and CD4 Vα2.3+ T cells in BALF.”
Sarcoidosis
Diagnosed using: tissue biopsy for noncaseating granulomas.
“Diagnosis is suggestive in a patient if one or more of the following is present: radiologic signs of sarcoidosis, evidence of systemic involvement, histologically confirmed noncaseating granulomas, sarcoidosis signs in bronchoalveolar lavage fluid (BALF), and low probability or exclusion of other causes of granulomatous inflammation.”
Treatment and management
What the research describes, not a recommendation. Treatment decisions belong with your clinician.
This covers treatments that appear in the published research mapped here. Investigational and experimental therapies are not included, so their absence is a boundary of this map, not a sign they do not exist.
corticosteroids
Corticosteroids are central to managing sarcoidosis when treatment is needed, dampening the inflammation that forms granulomas. Not everyone requires treatment, since the disease can resolve on its own; the decision is individual and made with the care team.
Used to help with: Sarcoidosis.
“Corticosteroid therapy, although central to sarcoidosis management, indirectly predisposes to OSA through weight gain, fat redistribution, and myopathy.”
corticosteroids (mainstay)
corticosteroids are the mainstay of treatment in sarcoidosis for people with symptoms and severely affected or declining organ function.
Used to help with: Sarcoidosis.
“Corticosteroids remain the mainstay of treatment for symptomatic patients with severely affected or declining organ function.”
methotrexate
methotrexate is one of the steroid-sparing immunosuppressive medicines that may be used in sarcoidosis for people who do not improve enough on glucocorticoids or who have side effects from them.
Used to help with: Sarcoidosis.
“Patients without adequate improvement while receiving a dose of prednisone of 10 mg/d or greater or those with adverse effects due to glucocorticoids may be prescribed immunosuppressive agents, such as methotrexate, azathioprine, or an anti-tumor necrosis factor medication, either alone or with glucocorticoids combined with appropriate microbial prophylaxis for Pneumocystis jiroveci and herpes zoster.”
anti-TNF medication
an anti-tumor necrosis factor medication is one of the steroid-sparing options that may be used in sarcoidosis for people who do not improve enough on glucocorticoids or who have side effects from them.
Used to help with: Sarcoidosis.
“Patients without adequate improvement while receiving a dose of prednisone of 10 mg/d or greater or those with adverse effects due to glucocorticoids may be prescribed immunosuppressive agents, such as methotrexate, azathioprine, or an anti-tumor necrosis factor medication, either alone or with glucocorticoids combined with appropriate microbial prophylaxis for Pneumocystis jiroveci and herpes zoster.”
How to read the evidence labels
Where this comes from
This guide is built from 11 published source(s). Every claim above links back to one of them. Click any source ID to read the original on PubMed.
Take it further
Printed, source-linked documents built from this condition's graph — ready to bring to an appointment or attach to a coverage request. Every claim carries its published source, the same as this guide.