Sarcoidosis symptoms will often get better on their own slowly without treatment.
Patients whose eyes, heart, nervous system, or lungs are involved may need to be treated with corticosteroids (prednisone or methylprednisolone). Therapy may continue for 1 or 2 years. The most severely affected patients may need lifelong therapy.
Drugs that suppress the immune system (immunosuppressive medicines) are sometimes also needed:
The drug used most often is methotrexate, but azathioprine and cyclophosphamide are also sometimes recommended.
Hydroxychloroquine is useful for skin sarcoidosis.
Rarely, some people with end-stage heart or lung damage may need an organ transplant.
Many people with sarcoidosis are not seriously ill, and the disease may get better without treatment. About 30 - 50% of cases get better without treatment in 3 years. About 20% of people whose lungs are involved will develop lung damage.
The overall death rate from sarcoidosis is less than 5%. Causes of death include:
Bleeding from the lung tissue
Heart damage, leading to heart failure and abnormal heart rhythms
Weinberger SE. Sarcoidosis. Goldman L, Ausiello D. Cecil Textbook of Medicine. 23rd ed. Philadelphia, Pa:Saunders Elsevier; 2007:chap 95.
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.