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Sarcoidosis

Cortisol, antibodies and sarcoidosis

04/04/2006

Question:

Can sarcoidosis increase cortisol levels? Is there any relationship between sarcoidosis and developing autoimmune hypothyroidism? I had sarcoidosis when I was 10 years old. I am now near 50 and my doctor has told me I have elevated TSH, antibodies to my thyroid hormone and high cortisol. I am going to see an endocrinologist but I would like to now if these conditions are associated with active sarcoidosis. Also, I would like to know if the appearance of a large circular red patch near the ankle and another one on the palm of the hand, in addition to the conditions mention above could signal active sarcoidosis. Thank you.

Answer:

Autoimmune hypothyroidism in association with sarcoidosis has been previously reported in the literature. Likewise, high levels of cortisol (Cushing's syndrome) have been reported in association with sarcoidosis. However, it is not clear if autoimmune thyroid disease or Cushing's syndrome are causally related to sarcoidosis. Other diseases (e.g., asthma) occur in the setting of sarcoidosis and are not necessarily linked to one another. Skin rash is also common with sarcoidosis, but the type of skin rash you describe and the new onset (is it new?) at this late stage of the disease suggests that the rash may be unrelated to sarcoidosis.

In addition to consultation with an endocrinologist for thyroid and adrenal disease, I would recommend consultation with a dermatologist to evaluate the skin rash.

I hope this information is helpful.

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Response by:

Elliott D Crouser, MD Elliott D Crouser, MD
Associate Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University