Vague, common symptoms lead to under-treatment of sarcoidosis
CHICAGO, June 6, 2017—Women, particularly those of African American descent, are most at risk of sarcoidosis, the most common fibrotic lung disorder in the U.S. Osteopathic physicians stress that this once rare disease, now affecting more than 200,000 patients, can be tricky to diagnose because of its vague, varied symptoms.
Sarcoidosis is a multi-system inflammatory disease that affects one or more organs, most commonly the lungs and lymph nodes, and often goes untreated. In the U.S., African American women have a nearly three percent lifetime risk for developing it, says Daniel Culver, DO, director of the Sarcoidosis and Interstitial Lung Disease Program at the Cleveland Clinic.
"About 90 percent of patients have it in the lungs," says Dr. Culver. "The lung symptoms, which can include coughing, wheezing and chest discomfort, are often misdiagnosed as asthma." Other common symptoms include fever, joint pain, fatigue, rash, vision problems, headaches and abnormal heartbeat.
Women have a higher risk than men and tend to get it later in life than men. African Americans develop sarcoidosis at a higher rate than other races and about 2.5 times more often than Caucasians.
Don’t Dismiss Symptoms if You’re at Risk
“Awareness is essential, especially among the African American community,” said Dr. Jen Caudle, a board-certified osteopathic family medicine physician and assistant professor at Rowan University School of Osteopathic Medicine. “While a lingering cough or flu-like symptoms may not seem threatening, these symptoms may be a sign of sarcoidosis. It’s a serious, but treatable chronic disease.”
Jacqueline Stewart was diagnosed with sarcoidosis after a bad case of pneumonia led her to the emergency room, where chest X-rays revealed granulomas in her lungs. She now relies on an inhaler to manage her asthma-like symptoms, and still experiences regular flare-ups that limit her ability to function for approximately two weeks at a time.
“I experienced periodic chest pain and flu-like symptoms, but I thought it would pass,” says Stewart. “I was taught to be tough. I wish I’d gone to the doctor sooner.”
An inflammatory disease, sarcoidosis causes abnormal nodules called granulomas to form in the affected organs, and can occur in almost any part of the body. No single test exists to identify the disease. An X-ray or biopsy will often reveal the disease and its location. In many cases, the patient will have granulomas in more than one organ, requiring treatment from multiple specialists.
Granulomas in Stewart’s lungs limit her ability to walk distances or climb stairs. Her flare-ups—when not quickly treated with steroids—often require hospitalization.
African Americans tend to have more granulomas, causing their disease to be more severe.
Sarcoidosis symptoms often overlap with other illnesses, which can hinder diagnosis. Many people have very few or no symptoms of the condition, while others experience severe effects that can interfere with daily life. Your family physician can help determine whether additional testing is required.
Despite increased prevalence among certain subgroups, Dr. Caudle cautions that sarcoidosis can impact all ethnicities and genders.
About the American Osteopathic Association
The American Osteopathic Association (AOA) represents more than 129,000 osteopathic physicians (DOs) and osteopathic medical students; promotes public health; encourages scientific research; serves as the primary certifying body for DOs; and is the accrediting agency for osteopathic medical schools. Visit DoctorsThatDO.org to learn more.