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Sarcoidosis

Symptoms & is it truly Sarcoidosis?

08/18/2006

Question:

Back last December, I started having symptons of headaches, sore throat and slight ear infection. In January when these symptons progressively got worse, I went to my general doctor and he started treating me with antibiotics. I was on a series of 4-5 different antibiotics for almost 8 weeks. During this period, I started having signs of fatigue, more severe headaches and joint pain. My doctor was baffled and sent me to a pulmonalgist for further testing. They did a CT scan and saw some light scaring but thought that was from pneomonia years ago? They saw nothing else, but also said that if it was sarcoidosis that I could be at the end of the cycle and it wouldn`t show up. By April of this year, I was feeling back to normal but had some days when I could barely function. Within the last couple of weeks, some of my symptons are coming back, tiredness, progessive cough and severe headaches--Im afraid its going to turn full-fledge again. My question is, I do not fall into the normal pattern of someone who gets this disease, I am a white female, 42 years old, no family history of the disease, have no skin rashes (had eczema years ago, but no recent reoccurances) so could this really be what I have?? I have seen 2 doctors, one said sarcoidosis and one said maybe its asthma. What do you suggest I do?

Answer:

Dear Madam-

You raise some excellent questions.  First of all, you have not provided enough information to convince me that you have sarcoidosis.  In this regard, sarcoidosis is a diagnosis of exclusion and testing is usually needed, including biopsy of affected tissues, in order to determine if you actually have the disease.  Once the diagnosis is established, it becomes necessary to track the activity of the disease.  Although sarcoidosis more often afflicts African Americans, it is not unusual for the disease to be present in a person with your background.  Only a fraction (about 10%) of sarcoidosis cases have skin disease.  

Thus, I would recommend that you and your doctors get together to confirm the diagnosis of sarcoidosis.  If sarcoidosis is confirmed, it is likely that your symptoms may be related to reactivation of the disease.  Decisions relating to how to treat the disease are best managed by a physician experienced in the care of sarcoidosis patients.

Sincerely,

Elliott Crouser, MD

The Ohio State University Medical Center

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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