Care and mobility considerations

Functional limitations are more common in patients in the chronic, progressive form of sarcoidosis.

The majority of patients will have minimal or no disability. The information summarised below should be used as a guide and each case must be assessed individually.

Mild Functional Restriction

Mild disease may be unnoticed and only identified on a routine chest x-ray

Effects of mild disease may include:

• Fever and night sweats
• Fatigue
• Mild chest pain
• Malaise
• Weight loss
• Arthralgia (aching joints)
• Erythema nodosum,
• Granulomas on conjunctivae
• Enlarged liver and spleen

A person with mild sarcoidosis would not normally have any care or mobility needs.

Moderate Functional Restriction

Effects of moderate disease may include:

• Moderate cough and shortness of breath - Please see COPD. Unlikely to have significant care or mobility needs.
• Glaucoma - Anterior Uveitis - Treatable, disabling effects will not last more than a few weeks.
• Joint tenderness and inflammation - treatable, disabling effects will not last more than a few weeks.
• Diabetes insipidus (pituitary gland affected) -- Treatable in a few weeks
• Skin plaques, and lupus pernio - the affected person may have a very poor body image, and suffer from depression, which may affect motivation, but the activities of daily living would not otherwise be significantly affected.
• Facial palsy - speech and eating are likely to be affected, for as long as the facial palsy is present; it depends on the individual.

Therefore, a person with “moderate” sarcoidosis may have some specific care and mobility needs, if the effects are not treatable. If the effects are treatable, the disabling effects would normally last no longer than a few weeks.

Severe Functional Restriction

Effects of Severe Disease may include:

• Severe lung disease (lung fibrosis) with severe restrictive effect causing severe breathlessness on exertion and/ or cor pulmonale (right heart failure due to lung disease).
• Blindness caused by posterior uveitis or glaucoma. Click here for disabling effects of severe visual impairment.
• Heart granulomas causing sarcoid cardiomyopathy heart failure or arrythmias which could be fatal. Click here for ischaemic heart disease, severe heart failure, and severe cardiac arrythmias)
• Kidney failure from untreated hypercalcaemia
• Severe joint tenderness and inflammation caused by bone cysts.

Amended November 2008