The disease also can affect the liver, skin, heart, nervous system and kidneys. Some people have symptoms related to a specific organ, such as shortness of breath, but others may have only a vague feeling of illness or no symptoms at all.

Although anyone can develop sarcoidosis, the disease mainly affects adults between the ages of 20 and 40.

Sarcoidosis remains something of a medical mystery, but it's believed to result from an abnormal immune response. Just what triggers this response isn't known. Doctors do know that the disease often goes away on its own without treatment - usually within 24 to 35 months. Some people may have symptoms for a lifetime, however. And in rare cases sarcoidosis can be fatal.

Signs and symptoms

Sometimes sarcoidosis develops gradually and produces signs and symptoms that last for years. Or it may appear suddenly and then disappear just as quickly. In either case, signs and symptoms can vary, depending on which organs are affected and how long you've had the disease.

Sarcoidosis that affects only your lungs, for example, may cause few, if any, symptoms. In fact, you may not know you have the disease until it shows up on a routine chest X-ray. More advanced lung disease may cause shortness of breath (dyspnea) and a cough that won't go away.

Other signs and symptoms of sarcoidosis include:

• A vague feeling of discomfort and fatigue

• Fever

• Weight loss

• Small red bumps on your face, arms or buttocks, a condition more common in blacks than in whites

• Red, watery eyes

• Arthritis in your ankles, elbows, wrists and hands, commonly associated with bumps in the skin over your shins (erythema nodosum)

• Fatigue

• Tuberculosis

Causes

Doctors don't know the exact cause of sarcoidosis, although they think it may occur when your immune system overreacts to an unknown toxin, drug or pathogen that enters your body through your airways and lungs. Some experts speculate that the causative agent may be a nontuberculous mycobacterium, a member of the family of bacteria that cause tuberculosis. In a small portion of people, sarcoidosis may have a genetic component.

Normally, your immune system helps protect your body from foreign substances and invading microorganisms such as bacteria and viruses. But in sarcoidosis, T-helper lymphocytes — white blood cells that play a key role in your immune response — seem to respond too strongly to a perceived threat. This triggers small areas of inflammation called granulomas.

As the disease progresses, granulomas and scarring (fibrosis) may occur in the tissue between the air sacs, stiffening your lungs and reducing the amount of air your lungs can hold.

Risk factors

Anyone, of any race or age, can develop sarcoidosis. But the following factors make it more likely you'll get the disease:

• Race. Black poeple are far more likely to develop sarcoidosis than are white poeple. And although sarcoidosis affects white men and women about equally, black women get the disease twice as often as black men do.

• Ethnicity. People of Scandinavian, German or Irish descent have an increased risk.

• Age. Sarcoidosis normally occurs between the ages of 20 and 40. It rarely affects children, but can occur in adults older than 50.

When to seek medical advice

You may not realize you have sarcoidosis, especially early in the disease. But if you're tired, have a fever, have lost weight, have shortness of breath and a cough that persists for weeks or months, or have raised skin eruptions and joint pain (arthralgia), see your doctor — these symptoms may indicate sarcoidosis.

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