Stages of Sarcoidosis


I've heard folks mention the various stages of Sarcoidosis. What are they? And do you know where I can find information on the various stages?



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Hi Warren,
Yes, some doctors do dx sarc in stages by your symptoms and how bad you are. I asked one of my sarc dr's this question and he said that it's not like the stages in cancer. You can have sarc but no symptoms of the illness that is considered stage 1, if you have lesions and they are active that is a higher stage like 3 maybe. I just know that I have this illness and that it is every where in my body and don't use stages.
We all have this illness and it is a bad nasty life sucking bug that just won't go away.

Wish you the best of luck,

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Unfortunately when the Scadding Scale was originally introduced there wasn't a lot of attention paid to the language that was applied and it has stuck. I say this because the term "Stage" is very misleading here. Let me elaborate:
The Scadding Scale from which these "stages" derive is a way to look at the chest x-ray and try to get a ballpark estimate on the chance of remission (really, it seems for within the next 18 months although was initially intended to describe chance for remission at all). There really is not a true progression through stages like you would find in cancers, congestive heart failure or kidney disease.
It is also important to point out these "stages" are only based on a chest x-ray and are no more than a loose description of the findings there. There is no association with any of the stages and treatment failure - although certainly the fibrotic changes that are described in Stage 4 or milliary sarc would be more problematic to treat.

Having said that, the scale is actually defined as:
Satge 1: Bilateral hilar lymphadenopathy (large lymphnodes near the main bronchi on both lungs) sometimes with large nodes near the trachea as well.

Stage 2: Bilateral hilar adenopathy with reticular opacities (this is the x-ray I use as a pic).

Stage 3: Reticular opacities - mostly in the upper lobes - with shrinking hilar nodes.

Stage 4: Reticular opacities with volume loss in the lung, mostly in the upper lobes, and contraction of the airways (traction bronchiectasis) often with conglomerated masses. Often calcification, cavitation or cyst formation will be seen as well.

Nodular: multiple, bilateral lung nodules and minimal hilar adenopathy - it may even resemble metastatic disease and the nodules often have poorly defined borders.

That's the Scadding scale - it says nothing about how severe symptoms are or how someone will respond to treatment and certainly doesn't take sarc outside the lungs into account. A lot of sarc specialists and pulmonologists are moving away from using this at all.

Hope that helps

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Sounds like I'm a stage 4 according to that :)

Pretty sure I'm at the final stage on any sarc scale.

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Sarcoidosis and the Body
Sarcoidosis is a "multiorgan" disease - meaning it almost always involves more than one organ. It's unpredictable and affects different people in different ways.

You can learn about the ways in which sarcoidosis affects the body in FSR's Sarcoidosis and the Body brochure.

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