How Is Sarcoidosis TREATED

Treatment of Sarcoid.Your doctor may not need to find every one of your organs affected by sarcoidosis, only those that cause symptoms. Often the organs affected by the condition continue to function well and don't need to be treated.

Treatments for Specific Types of Sarcoidosis
Eyes. Sarcoidosis in your eyes almost always responds well to treatment. Often, the only treatment you need is eye drops containing corticosteroids. You should have yearly eye exams, even if you think your eyes are doing well.
Spleen. Sarcoidosis can cause your spleen to become larger. This can lead to a decrease in your red or white blood cells or platelets and increase your chances of infection and blood clotting disorders. Treatment is usually given to increase the number of your blood cells and ease your pain. In rare cases, your spleen may need to be removed.
Liver. Sarcoidosis rarely causes permanent liver damage. As a result, your liver usually isn't treated unless it's causing major symptoms (e.g., fever). Drug treatment can usually reduce granulomas in your liver. Liver transplantation has been successful in those rare cases in which the condition has become worse.

IVIG helps all symptoms in all organs and early treatment can reverse disease. It is best to search for a infection and treat it asap.bacteria (Borrelia burgdorferi, Proprionibacterium acnes, species) and viruses (Human herpesvirus 8, Epstein-Barr virus,Cytomegalovirus and Coxsackie B) . Metals (beryllium and zirconium), minerals (talc and clay), and organic substances (pine tree pollen) have also been proposed as etiologic agents Followup care includes regular blood tests to find out how well your liver is working. You should check with your doctor to find out how often you need these tests.
Nervous system. Sarcoidosis in your nervous system (neurosarcoidosis) usually needs treatment. Nerve tissue heals slowly, so treatment often takes a long time. You may need to take several drugs at high doses.
Erythema nodosum. These painful bumps on your shins often go away in weeks to months without treatment. Your doctor probably will not give you medication unless you are very uncomfortable. Aspirin or ibuprofen, an anti-inflammatory drug that you can buy without a prescription, will usually help.
Heart. Sarcoidosis in your heart is usually treated with steroids. You may also be given heart drugs to improve your heart's pumping ability or to correct a disturbed heart rhythm.
If you have a severe heart rhythm disturbance, your doctor may prescribe one of these devices:
A cardiac pacemaker, a small battery-operated device, often put under your skin, that regulates your heartbeat
A defibrillator, an implanted device that shocks your heart into a normal heartbeat or, if it has stopped, into beating.
If your heart is severely affected and doesn't respond to treatment, a transplant may be done. But this is rarely needed.
Lupus Pernio. This rash on your face, especially your cheeks and nose, can be distressing because it's in a very visible area. It often occurs with loss of your sense of smell, nasal stuffiness, and sinus infections.
Options for treatment include:
Local treatment with skin creams
Oral drugs (plaquenil or prednisone, for example)
Local injections of steroid preparations.
Lupus pernio is often treated by dermatologists, doctors who specialize in skin diseases, working with a sarcoidosis specialist.
Because sarcoidosis varies so much among different people, your doctor may find it hard to tell whether the treatment is helping.

 Other Drugs Being Studied for Possible Use in Treating Sarcoidosis
Scientists also are studying drugs that are used for other conditions to see if they can help people who have sarcoidosis. These drugs include:

Etanercept (Enbrel). This drug is an immune system suppressant. It's injected under the skin to reduce symptoms of rheumatoid arthritis. It may also be used to treat psoriasis (so-ri'ah-sis) or ankylosing spondylitis (ang"ki-lo'sing spon"di-li'tis), a type of arthritis that affects the joints in the spine. Early studies suggest that it will not be useful in treating sarcoidosis, but research is ongoing.
Infliximab (Remicaide). This drug is an immune system suppressant. It's injected into a vein in your arm. It's used to treat Crohn's Disease, rheumatoid arthritis, and ankylosing spondylitis. Some studies have shown it to help sarcoidosis patients who also have lupus pernio, eye disease, or neurosarcoidosis. This drug has serious side effects but may improve lung function in some people who aren't helped by corticosteroids. More research is needed.

Tetracycline. Tetracycline antibiotics are used to treat Lyme Disease, some types of pneumonia, and acne. A few small studies suggest that they may help in treating sarcoidosis in the skin, lungisues. Research is ongoing.
Thalidomide. This immune system suppressant can cause bad side effects. It is effective against other conditions that involve granulomas of the skin (e.g., leprosy, tuberculosis). Scientists are studying this drug to see if it can be used to treat sarcoidosis in the skin. More studies are needed.

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