Sarcoidosis
Sarcoidosis, also known as Beisner-Boeck disease, is a disease of the immune system that causes small inflammatory nodules, especially in young people.  The actual cause of sarcoidosis is not known but it can involve almost any body system. The clinical course of the disease varies from person to person, and there are those that die from the disease. 
Sarcoidosis affects young people of equal sexes, although there is a slight preponderance of women.  The peak age of onset is 20-29 years of age but it can occur as old as age 50.  The disease occurs throughout all continents and occurs in 16.5 out of 100,000 individuals.  There are more people from Northern European countries that become afflicted. In the US, African-Americans are more likely to be affected. 
Signs and Symptoms
Sarcoidosis is systemic and can take over any organ system.  The most common symptoms are fatigue, poor energy, loss of weight, joint aches and pains, joint pains, blurry vision, dry eyes, a dry cough, shortness of breath and certain skin lesions.  The skin symptoms are variable and can be as simple as small bumps to what is called erythema nodosum.  The skin symptoms often have no symptoms.
Sufferers who have hilar lymphadenopathy, joint pains and erythema nodosum have what is called Lofgren Syndrome, a type of sarcoidosis with a poor prognosis.  Kidney, heart, liver or brain involvement may further worsen the patient’s condition. Brain involvement is called neurosarcoidosis. 
Diagnosis
One will find a high calcium level called hypercalcemia.  Doctors will find a restrictive lung disease that results in a restricted lung volume and poor lung compliance.  This limits the amount of air allowed into the lungs but expiratory flow rates are higher than normal.  One may also find obstructive lung disease, especially when enlarged lymph nodes push on the airways exteriorly.  It also occurs when there is internal inflammation or sarcoid nodules that block airflow. 
The Chest XRAY findings are found in four stages:  First there is bihilar lymphadenopathy, then there is bihilar lymphadenopathy plus reticularnodular infiltrates, then there is bilateral infiltrates and finally, one finds fibrocystic sarcoidosis with cystic and bullous changes in the lungs. 
Because sarcoidosis can affect the heart, an electrocardiogram should be done as well as an eye exam due to eye involvement.  A serum and 24-hour urine calcium should be assessed.  Women with sarcoidosis often get hypothyroid disease and so that close follow up of the thyroid should be undertaken. 
Causes of the Disease
The precise cause of the disease of sarcoidosis isn’t known.  It is believed that it is related to genetics and that environment has something to do with it as well.  It is believed that there is an alteration in the immune response following some kind of exposure to something in the environment or to an occupational exposure or to an infectious disease. 
Studies in sarcoidosis have led to findings in genetics and genetic markers for the disease have been found.  Certain HLA types have been found to be associated with the disease. 
Infectious diseases appear to be related to the disease but none are completely clear-cut. The bacterium Propionibacterium acnes has been found in 70 percent of lung lavages of those with sarcoidosis.   It is found in only 23 percent of controls.  Mycobacterium also is associated with the disease. 
The hormone, prolactin, is found in sarcoidosis in about 3-32% of cases.  It causes lack of menses, galactorrhea and breast disease in women who suffer from the disease. 
Treatment
The bulk of the patients (30-70%) do not require any treatment.  Prednisone or other corticosteroids have been the most useful treatment for years.   Immunosuppressants have also been used.  Due to a negative redox situation, antioxidants such as glutathione are known to be successful in treating the lung portion of the disease. 
Almost half of the cases of sarcoidosis go away within 12-36 months and even more get better within five years.  A few cases last several decades.