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Treatments and drugs
By Mayo Clinic staffYou may not need treatment if you don't have any signs and symptoms of sarcoidosis or if they aren't bothering you. Sarcoidosis goes away on its own in many cases, but you should undergo close surveillance with regular chest X-rays and exams of the eyes, skin and any other organ involved. Treatment becomes necessary if organ function is threatened.
Medications
- Corticosteroids. Prednisone and other corticosteroids are the first-line treatment for sarcoidosis. In some cases, these powerful anti-inflammatory drugs can be applied directly to an affected area — via a cream to a skin lesion or with an inhaler to your lungs. Oral corticosteroids affect your whole body and can cause weight gain, mood swings, insomnia and weakened bones (osteoporosis).
- Anti-rejection drugs. Drugs such as methotrexate (Trexall) or azathioprine (Imuran) reduce inflammation by suppressing your immune system. But these drugs carry their own risks, such as making you more vulnerable to infections.
- Anti-malarial drugs. Hydroxychloroquine (Plaquenil) may be helpful for skin disease, nervous system involvement and elevated blood-calcium levels. Anti-malarial drugs can harm your eyes, so regular eye exams should be scheduled
- TNF-alpha inhibitors. Tumor necrosis factor-alpha (TNF-alpha) inhibitors are most commonly used to treat the inflammation associated with rheumatoid arthritis. Some studies have indicated that infliximab (Remicade) is also helpful in treating sarcoidosis. Potential side effects include congestive heart failure, blood disorders and lymphoma.
Surgery
Organ transplant may be considered if sarcoidosis has severely damaged your lungs or liver.
- Sarcoidosis. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/sarc/sar_whatis.html. Accessed April 21, 2010.
- Ferri FF. Sarcoidosis. In: Ferri's Clinical Advisor 2010. Philadelphia, Pa.: Mosby Elsevier; 2009. http://www.mdconsult.com/das/book/body/196535409-4/986729825/2088/583.html#4-u1.0-B978-0-323-05609-0..00028-9--sc0020_11937. Accessed April 21, 2010.
- Weinberger SE. Sarcoidosis. In: Goldman L, et al. Cecil Medicine. 23rd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/196535409-4/986729825/1492/382.html#4-u1.0-B978-1-4160-2805-5..50100-2_4032. Accessed April 21, 2010.
- Dempsey OJ, et al. Sarcoidosis. British Medical Journal. 2009;339:620.
- King TE. Patient information: Sarcoidosis. http://www.uptodate.com/home/index.html. Accessed April 21, 2010.
- Rosenow EC (expert opinion). Mayo Clinic, Rochester, Minn. May 5, 2010.
- King CS, et al. Treatment of sarcoidosis. Disease a Month. 2009;55:704.
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