Sarcoidosis is usually a mild condition, and many patients have no symptoms. Most develop minor symptoms that do not get any worse. Serious symptoms are uncommon, but in rare cases sarcoidosis can be fatal. Although onset can occur suddenly with immediate symptoms, sarcoidosis usually develops slowly and produces symptoms only after it has been present for some time.

Symptoms vary greatly depending on the extent of the disease and which organs it affects. Sarcoidosis can occur in any organ and affects more than one.

The organs most commonly affected by sarcoidosis include:

• Lungs. Symptoms may include shortness of breath (dyspnea), lasting cough or chest pain. The lungs are the most commonly affected organ.  Chronic production of sputum and blood in sputum are common in advanced stages.
  
  
• Lymph nodes. Swelling of lymph nodes in the neck and chest may cause pain.
  
  
• Liver. Although the liver is commonly affected by sarcoidosis, the disease may produce no symptoms there or may involve some abdominal pain.
  
  
• Eyes. May produce eye pain, redness, dry eyes, light sensitivity, cataracts and seeing black spots. In some cases, sarcoidosis in the eyes may lead to glaucoma, a leading cause of blindness.
  
  

  

• Skin. The main symptom is warm, tender, red bumps or painful, purplish red, slightly raised bumps (erythema nodosum). These may be accompanied by fever, joint pain or skin lesions.  Disfiguring skin sores affecting the nose, cheek, ears and fingers can occur.

Sarcoidosis has an active and inactive phase.  In the active phase, the granulomas grow.  In the inactive phase, inflammation goes down and granulomas shrink in size, but scarring can persist and can cause symptoms to persist also.

Lofgran syndrome is acute sarcoidosis characterized by erythema nodosum, bilateral hilar lymphadenopathy (an infection and inflammation of lymph nodes in the lungs), polyarthritis and, commonly, uveitis (an eye inflammation).  It is common among Scandinavians and the Irish, especially women, but occurs in less than 5 percent of the African American population with sarcoidosis.

Several other organ systems are less commonly affected by sarcoidosis. These include:

• Joints and bones
• Skeletal muscle
• Spleen
• Heart 
• Nervous system
• Salivary glands (involvement may cause dry mouth)
• Tear glands
• Sinuses

Rarely, sarcoidosis affects the thyroid gland, kidneys, breasts or reproductive organs.

Despite the relative rarity of sarcoidosis in these systems, the disease may cause serious long-term effects there. For example, sarcoidosis in the heart may lead to heart failure, and sarcoidosis in the nervous system (neurosarcoidosis) may lead to paralysis or coma.

Regardless of where the disease occurs, calcium levels in the urine are likely to be elevated. Calcium levels may also be elevated in the blood. The granulomas (collections of inflammatory cells) associated with sarcoidosis produce activated vitamin D, which enhances calcium absorption from the intestine. If prolonged, this may lead to kidney stones and calcium deposits in the kidneys. In rare and severe cases, the kidneys become unable to function because of the high levels of calcium, and kidney failure may result. Other symptoms of this elevation in calcium include:

• Loss of appetite
• Nausea
• Vomiting
• Thirst
• Excessive production of urine (polyuria)

Other general symptoms that a patient may experience regardless of what organs are affected include:

• Recurring fever
• Fatigue
• Malaise (overall feeling of ill health)
• Night sweats