In News:

• Sarcoidosis is a chronic inflammatory diseasecharacterised by the formation of granulomas—small clusters of immune cells—in multiple organs, most commonly the lungs and lymph nodes.
• The condition has a highly variable clinical course, ranging from asymptomatic or mild presentations to severe, life-threatening complications.
• Recent peer-reviewed studies, including those published in Nature Reviews Disease Primers,emphasise the importance of early diagnosis, timely intervention, and awareness of risk factors in improving patient outcomes.

Causes and Risk Factors

• The exact cause of sarcoidosis remains unknown, but evidence points towards a combination of genetic susceptibility, immune system overactivity, and environmental triggers.
• Possible stimuli include bacteria, viruses, dust, and chemical exposure. Certain gene variations may predispose individuals, with the immune system reacting abnormally, leading to chronic inflammation and granuloma formation.

Symptoms and Clinical Manifestations

Symptoms vary depending on organ involvement:

• Pulmonary (most common): persistent cough, shortness of breath, chest pain; advanced cases may progress to pulmonary fibrosis and respiratory failure.
• Skin: rashes, bumps, or nodules; tender sores (erythema nodosum).
• Eyes: redness, pain, blurred vision.
• Cardiac: irregular heartbeats, heart failure.
• Neurological: seizures, facial paralysis, or peripheral nerve damage.
  Some patients remain asymptomatic, with the disease detected incidentally during routine examinations.

Diagnosis
Diagnosis requires a combination of clinical evaluation, imaging, and biopsy.

• Chest X-rays/CT scans often reveal characteristic granuloma patterns.
• Biopsy confirms non-caseating granulomas, distinguishing sarcoidosis from infections and malignancies.
• Blood tests and lung function tests help assess disease activity and organ damage.

Treatment Approaches

There is no definitive cure for sarcoidosis, but management depends on severity and organ involvement:

• Mild/asymptomatic cases: often require only observation and regular monitoring.
• Moderate to severe cases: treated with corticosteroids (e.g., prednisone) to suppress inflammation.
• Refractory cases: immunosuppressive agents (methotrexate, azathioprine) or biologic therapies targeting immune pathways.

Long-Term Outlook

The prognosis is highly variable:

• Many cases resolve spontaneously within a few years.
• Others may become chronic, causing permanent lung scarring, cardiac complications, or organ dysfunction.
• Early detection and continuous monitoring remain critical to preventing irreversible damage.

Public Health Relevance

Sarcoidosis highlights the complex interaction between genetics, immunity, and environment. Its unpredictable nature underlines the need for:

• Awareness campaigns for early recognition of symptoms.
• Strengthening diagnostic infrastructure in primary healthcare.
• Research on genetic predispositions and immunological mechanisms to develop targeted therapies.