The cause of sarcoidosis is not known. Several underlying causes may be related to different patterns of the illness, such as the variances between short-term or long-term occurrence or between race and ethnicity.
Abnormalities in the immune system play a part in sarcoidosis. The formation of granulomas (collections of inflammatory cells) is a function of the immune system. Some studies have demonstrated abnormalities in certain cells (e.g., T cells, cytokines) involved in the immune response in some patients.
A genetic predisposition to sarcoidosis seems likely in at least some individuals. The disease has been known to occur in families. Certain genetic factors may also confer a susceptibility or resistance to sarcoidosis.
Racial and ethnic differences may affect the form of the disease and the organs affected. For example, among Japanese people, the heart and eyes are often affected, and in Northern Europeans the skin is commonly affected, although some other organ (e.g., lung) is also affected. Fever and joint pain typically accompany skin involvement.
In the United States, sarcoidosis affects black people slightly more often than white people. Black Americans are more likely to be affected for a short period of time but with more severe symptoms, including neurosarcoidosis (involvement of the central nervous system), and black women are affected much more than black men. White people have a more equal gender distribution of sarcoidosis, and the symptoms are milder. The cause of these differences is not known.
Various infectious agents, particularly bacteria, have been suspected of causing sarcoidosis. Some studies have reported the presence of bacteria in the blood of some sarcoidosis patients. There have been occasions of the transmission of the disease after heart and bone marrow transplants. However, clinical research has not conclusively demonstrated that infections play a role in sarcoidosis development.
Age may be a factor in the development of sarcoidosis. The disease typically affects young adults between the ages of 20 and 40. It rarely affects children and uncommonly occurs in older adults.
A recent multicenter study on the etiology (cause) of sarcoidosis found little evidence for dominant or common environmental or occupational exposures associated with an increased risk of developing sarcoidosis. For unknown reasons, the disease occurs more often in healthcare workers and more commonly in nonsmokers than smokers.
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