Sarcoidosis: Reggie White's disease
The death of the football star brings awareness to a serious condition that can dehabilitate, or just lurk invisible in the body.
By ASSOCIATED PRESS
Published September 20, 2005
COLUMBIA, S.C. - When football great Reggie White died early this year, Eddie Glenn Bryant of Columbia was sad but also hopeful.
To Bryant, every mention of sarcoidosis - the mysterious ailment cited as a factor in White's death - means much-needed publicity for a disease that has had devastating effects in Bryant's own life.
"It gets misdiagnosed and it goes undiagnosed," said Bryant, 49, a former college instructor and administrator. "And nobody wants to talk about the ones who die."
Indeed, doctors say sarcoidosis symptoms usually are mild and often go away on their own. About half of sarcoidosis cases don't even have noticeable symptoms, said Dr. Marc Judson, a pulmonologist and professor at the Medical University of South Carolina.
Yet Judson said the public needs to know more about the disease. When someone does have sarcoidosis, it must be closely monitored, he said. Worst-case scenarios can be serious and disabling, including effects on the heart, lungs, liver, eyes and brain.
"It's fairly common, especially in African-Americans," Judson said. "It's estimated that about 3 percent of African-American women will get it at some point."
In sarcoidosis, white blood cells leave the bloodstream and form clumps called granulomas that may be deposited in the skin, lungs and other organs.
If you've heard of sarcoidosis, you might have heard it referred to as a lung ailment - but that's incorrect, Judson said.
"It's a total-body disease," he said.
The granulomas can be deposited in the lungs. Routine chest X-rays often are how the disease is first detected, he said. But these inflammatory clumps can show up almost anywhere. The cause of sarcoidosis is unknown, and the way it develops remains a medical mystery. In Europe, it is most common among Swedes. In this country, it is much more common among blacks than whites, Judson said.
There's even disagreement about the type of disease it is. Some doctors and patients regard it as an autoimmune disease - one in which the body misperceives an "invading" organism and starts destroying its own immune system.
Judson believes that's wrong. He thinks that there probably are multiple causes, but that the basic process involves something in the environment triggering an inflammatory reaction in people who already have a genetic tendency to develop the disease.
Studies have suggested various environmental factors as possible triggers, Judson said, including infectious agents such as bacteria, and even exposures to photocopier toner - in particular its ingredients of aluminum, silica and titanium.
The disease can cause lung scarring that leads to shortness of breath, inflammation that causes joint pain, irregular heart rhythms, liver and kidney damage, and lumps and discolored patches on the skin.
Symptoms may worsen as a patient struggles to find a diagnosis - all the more problematic because early symptoms may be mistaken for a variety of other ailments, said Dr. James Barker, a Columbia pulmonologist who treats sarcoidosis patients.
For example, he said, asthma and tuberculosis must be ruled out, along with lymphoma, a type of cancer.
"The drug of choice when you have to treat is prednisone," a corticosteroid, Judson said. Side effects of the medication can include weight gain, swelling, high blood pressure, cataracts, mood changes, infection and diabetes, he said.
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