Pulmonary Sarcoidosis and the Granulomas: What is it? Symptoms, Diagnosis and Treatment

It is a disease that can affect the whole body, especially the lungs, producing a series of cell-shaped inflammations (granulomas) in the tissues of the body.

The granulomas can grow and clump together, affecting the functioning of an organ in the body.

Why are granulomas formed?

It is not clear, but researchers think that sarcoidosis develops when the immune system responds to something in the environment.

The people most likely to develop sarcoidosis are:

  • Health workers.
  • The smokers.
  • Teachers of primary and secondary schools.
  • People exposed to agricultural dust, insecticides, pesticides or mold.
  • Firefighters.


Many people who have sarcoidosis do not have any symptoms. The disease was discovered by accident when a chest x-ray was performed for another purpose; although about a third of people with this condition have general symptoms such as:

  • Fever
  • Fatigue, weakness
  • Weight loss or loss of appetite
  • General discomfort
  • People with sarcoidosis whose lungs are affected by it (90% of individuals) have symptoms such as:
  • Short of breath
  • Dry cough
  • Wheezing
  • Discomfort in the chest, especially when coughing

Symptoms of the skin in sarcoidosis (25% of individuals) may include:

Itchy bumps , ulcers, or areas of discolored skin near the nose, eyes, back, arms, legs, or scalp.

Severe pain in the ankles or calf that are red or purple (called “erythema nodosum”). Sores inside the nose, on the cheeks, ears, eyelids or fingers (known as lupus pernio). Sarcoidosis can affect the eyes, heart and other organs of the body, causing additional symptoms. It can also cause pain in the joints and muscles. The symptoms can appear and disappear or last a long time.


A detailed medical history and a complete physical examination can help identify sarcoidosis. The doctor may perform a variety of tests, such as chest x-ray, pulmonary function tests, electrocardiogram (ECG), and a computerized tomography (CT) scan to look for signs and help with diagnosis. A sample of lung tissue (lung biopsy) is usually taken to look for the presence of granulomas.


Knowing how much of the body is affected and the active form of the disease will help determine the course of treatment. People who do not have symptoms usually do not require treatment. For those who have symptoms, prednisolone is the main treatment. Other medications, such as Rheumatrex (methotrexate) or Imuran (azathioprine), may be given together with prednisolone.

Other medications may be needed depending on the symptoms, such as eye drops or heart medications. Erythema nodosum usually goes away without treatment. Lupus pernio can be treated with creams or medications that are taken orally or injected into the skin.

The treatment for Sarcoidosis will be different for each person depending on how he or she is experiencing the disease.