Sarcoidosis: 15 Early Symptoms

1.

Fever

Fever

Sarcoidosis is a systemic illness defined by the presence of granulomas in many organs. The symptoms of sarcoidosis that patients experience are predominantly linked to organ involvement. However, the disease also causes vague systemic symptoms, and it can herald the onset of sarcoidosis. Such a symptom is fever.

The patients observe an increase in the temperature of the body. A low-grade fever is a constant feature of the course of sarcoidosis. However, there can also be high fever (40 °C), but it is less frequent. The symptoms of fever alone are hard to nail down. On the other hand, if exams fail to identify some source of acceptable infection, sarcoidosis could be the source of a high temperature of unknown origin.

2.

Dyspnea

Dyspnea

Sarcoidosis can impact multiple organs, although it commonly impacts on the lungs. Micronodules dispersed within the thorax, primarily along the lymphatic structures of the lungs. As a result, the disease triggers respiratory signs. One such complaint is dyspnea or shortness of breath. During the first stages of sarcoidosis, patients can experience an unpleasant feeling of insufficient aeration of the lungs.

As time goes by, the symptoms persist more and become chronic type. Commonly, dyspnea is explored in these patients due to undiagnosed, especially for people with sarcoidosis inflicting pulmonary fibrosis. Other factors could also modulate the intensity of dyspnoea. For example, some exertions can aggravate the symptoms.

3.

Enlarged Lymph Nodes

Enlarged Lymph Nodes

Enlarged lymph nodes can also be an important symptom of sarcoidosis. Lymph nodes are unique structures that are found in various regions of the body. Along with the lymphatic vessels, they play an important role in the immune system. So, lymph nodes have a defensive role in the human body. They swell and enlarge in case of an emergency.

Patients are able to see and feel it. Bacterial and viral infections commonly cause enlarged lymph nodes, but sarcoidosis may present this symptom, so something to remember. In fact, the lymph nodes are so much related to sarcoidosis that their enlargement may be the first symptom. Lymphocytes and macrophages are seen in the lymph nodes in sarcoidosis. The disease primarily involves lymph nodes in the hilar area of the lungs.

4.

Sweating

Sweating

Increased sweating is another early sarcoidosis symptom, which is quite significant as well. It is a symptom that can be very physically and psychologically uncomfortable. Night sweats are common in the course of the disease. You can identify this symptom when you wake up with your entire body damp and clothes cling to the body.

Night sweats are among the more common, non-specific symptoms. So, it may be a good idea to listen out for other troubling symptoms if they happen. Also, night sweats in sarcoidosis may occur in patients sleeping in cool rooms. They are also commonly associated with a fever. Recurrent sweating at night is not a sign of a fatal disease, but it may be a serious risk to be excluded. It is important to tell the doctor about these symptoms, particularly if sweating too much becomes an issue.

5.

Photophobia

Photophobia

In the same way that sarcoidosis can target the lungs, it can also target the eye. Thus , the disease can also lead to ocular symptoms. The disease can affect any part of the eye. As a result, one of the first signs could be a sensitivity to light. Patients with photophobia tolerate the light poorly. In well-lighted rooms, they might squint as their eyes find the light too bright.

Sarcoidosis can cause the inflammation that often leads to hypersensitivity to light. The most frequent ocular manifestation is uveitis. When such inflammation occurs with other chief signs, such as mild fever and also swelling of the parotid organ, sarcoidosis is strongly suspected. For this reason, ophthalmic screening is often carried out in the process of diagnosing this disease.

6.

Arrhythmias

Arrhythmias

Sarcoidosis is an illness that can damage any part of the body, including the heart. Damage to the heart can cause abnormal heart rhythm disturbances. This symptom may be presented to patients in different ways. The heart may thus beat too slowly, too fast, or in an irregular way. Patients may notice heart palpitations around and sometimes give up any pain altogether because of the arrhythmia. In more severe cases, syncope can result.

Also, a heart attack is the most dangerous complication of cardiac sarcoidosis patients. This disease is thus all the more essential to recognize and treat as early as possible. Cardiac sarcoidosis occurs less frequently than pulmonary sarcoidosis, but it is possible. Therefore, it is also worthwhile to watch out for such symptoms. This condition can be easily diagnosed by examination with a cardiac MRI.

7.

Liver and Spleen Enlargement

Liver and Spleen Enlargement

The term hepatosplenomegaly is a mouthful, but it simply refers to the spleen and liver enlargement of the human body. It occurs in severe diseases, and as a consequence, a detailed diagnosis is needed. So, how do you know that these parts are bigger? Enlargement of the liver has been noted on palpation. A little lower than the right rib arch, there is a bulge of that organ.

This can, in turn, put pressure on other organs within the liver itself, leading to painful symptoms. The spleen, on the other hand, is harder to palpate. However, a patient may find it difficult to bend and feel discomfort while doing some activities. If such symptoms are seen in you, it might be a sign of sarcoidosis, which also causes liver dysfunction.

8.

Facial Palsy

Facial Palsy

Neurological symptoms are also possible with sarcoidosis. Here, we are now talking about neurosarcoidosis. Central nervous system involvement in sarcoidosis is rare; however, neurological symptoms might be the disease’s first manifestation, leading to its diagnosis. Facial palsy is another critical symptom to watch for.

This symptom is often unilateral, but bilateral involvement may occur. Acute facial paralysis, which occurs suddenly, results from the destruction of the facial nerve fibers. When they look in a mirror, patients will see one corner of the mouth hanging lower. Problems with eyelid closure are also present. In some patients, speech may be affected due to paralysis. Their speech may be slurred. Note that this is another hint that requires you to visit a doctor as well since they can signal a stroke.

9.

Dry Cough

Dry Cough

A significant sign that can be seen in the initial stage of sarcoidosis is a persistent cough. These benign phenomena may truly signify this dangerous disease. Pulmonary sarcoidosis is diagnosed in a fair number of patients with cough. The cough may be dry and chronic, possibly with other symptoms. In these cases, it is important to do trial investigations to demonstrate the fact that inflammation and infection are present.

Cough is another prevalent symptom in cases involving viruses and bacteria. On the other hand, if the test findings do not point toward pathogens, there might be a suspicion of sarcoidosis. You then need additional testing that demonstrates that granulomas are found in at least one biopsy specimen.

10.

Papules

Papules

Sarcoidosis can also have dermatological presentation. In patients, lesions may appear in the form of papules and plaques in the skin. The area may also have some inflammation. More commonly, in patients, the skin problem is erythema nodosum. Affected persons have large and painful papules and redness at their skin sites. Skin lesions can form on the legs, arms, or trunk.

Papules resolve spontaneously and are not scarring. However, a symptom like that should not be overlooked, as it could be due to a serious illness. Sarcoidosis can also give rise to benign skin lesions. Typically, these take the form of small papules in the face, particularly the eyelids and nasolabial folds. Others may see scaly plaques on other areas of the body. They were also present in a range of colors, including flesh-colored, yellow, brown, red, etc.

11.

Joint Pain

Joint Pain

Many of the patients have joint involvement or sarcoid arthropathy. It results in painful symptoms that can affect multiple joints. Another possibility is joint deformity. Joint-related issues are quite troublesome for patients because they cause mobility problems and the execution of daily activities. Your joints are also vulnerable to injury in the disease course.

Physical activity can aggravate symptoms. Joint symptoms are also not infrequently mistaken for common  diseases (rheumatoid arthritis or other). In sarcoidosis, joint inflammation may also occur, but only by determining the source of the inflammation can treatment be carried out. So, one must conduct various essential diagnostic tests.

12.

Wheezing

Wheezing

Wheezing is another important symptom that can be present during sarcoidosis. This symptom happens when the disease attacks the lungs, which is the case in most cases. When patients breathe audibly, it can signal that their quality of care is essential to them. The lower airways are narrowed, and this is what causes wheezing. This makes assessing pulmonary function tests (PFTs) helpful during the diagnostic process.

Besides that, imaging studies demonstrate small pulmonary nodules. Patients can develop acute complications, such as pleural effusion and pneumothorax, in severe cases. On the other hand, chronic pulmonary sarcoidosis complications such as pulmonary fibrosis and respiratory failure are common. If serious symptoms like wheezing are recognized in advance, stopping these types of complications is achievable.

13.

Seizures

Seizures

Neurological manifestations of sarcoidosis include seizures. This may be an important symptom because it is associated with more severe and progressive or recurrent forms of central nervous system sarcoidosis and may be an early sign of these disorders. Muscle tension onsets may occur suddenly in the patient.

There are also uncontrolled movements. Some of the sensations that are reported are stiffness, twitching, or limpness. Seizures can become more frequent and severe as the disease progresses. These neurological symptoms during sarcoidosis are usually intractable. Thus, even after basic sarcoidosis treatment, seizures necessitate antiepileptic drugs.

14.

Weight Loss

Weight Loss

One more symptom we could mention is reduced weight. Before being diagnosed, the patients might find themselves losing weight and begin to get worried. What everyone fears is that spontaneous and unplanned weight loss may be indicative of cancer. However, other potential etiologies should be addressed, specifically sarcoidosis. The liver, spleen, and gastrointestinal tract are often affected, and weight loss is a common symptom.

Patients have lost weight despite having adequate calories and not changing their activity levels. These instances are almost always associated with other indications—such as high temperature and night sweats. In the presence of these symptoms together, testing for sarcoidosis should be given serious consideration because of the risk of organ dysfunction and hypercalcemia.

15.

Back Pain

Sarcoidosis can also affect the skeletal system, which can cause various symptoms. So, these patients often complain about lumbar pain. They may also have other types of pain and are at greater risk of bone fractures as well. This is related to the fact that sarcoidosis itself will lead to a decrease in bone density.

Osteoporosis occurs due to sarcoidosis, which attacks bones and makes them lose volume. Various activities become difficult with continuous drought and chronic pain. In addition, a marked reduction in height and figure alteration are visible symptoms. Patients will hunch over to escape from pain. Symptoms of osteoporosis usually appear in advanced stages.

Sources
  • Rashi Jain, Dhananjay Yadav, Nidhi Puranik, Randeep Guleria, Jun-O Jin (2020). Sarcoidosis: Causes, Diagnosis, Clinical Features, and Treatments.
    https://pmc.ncbi.nlm.nih.gov/articles/PMC7230978/
  • Pascal Sève, Yves Pacheco, François Durupt, Yvan Jamilloux, Mathieu Gerfaud-Valentin, Sylvie Isaac, Loïc Boussel, Alain Calender, Géraldine Androdias, Dominique Valeyre, Thomas El Jammal (2021). Sarcoidosis: A Clinical Overview from Symptoms to Diagnosis.
    https://pmc.ncbi.nlm.nih.gov/articles/PMC8066110/#sec2-cells-10-00766
Updated on February 4, 2025, by Emma Harrison
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