Was ist Sarkoidose?

Dr. med. Klaus Kögler


Sarcoidosis, formerly also called “Morbus Boeck”, is characterized by the development of granulomas (microscopic lumps in the connective tissue lumps). These granulomas can develop in any part of the body, causing then dysfunctions of the respective organ. The disease occurs frequently in young adulthood or in middle-aged adults, being more frequent among women than among men. The cause of sarcoidosis is up to now unknown.

80 000 people in Germany know that they suffer from sarcoidosis. Since this disease may cause a wide variety of disorders and since it is still scarcely taken into consideration, the number of undetected cases is estimated twice or triple as high. This presumption is sustained by pathological reports.


Which organs may be concerned?
In most of the cases the lymph nodes are swollen. The lung is almost always affected. Other organs can be involved before, afterwards or simultaneously, for example the eyes, the heart, the skin, the kidneys, the liver, the spleen, the muscles, the joints, the bones and the nervous system. Unfortunately, the eyes are frequently affected. This can lead to serious damages of the vision, if it is not detected and treated in time. The cardiac sarcoidosis occurs more frequently than presumed in the past.


What are the symptoms?
In case of symptoms, such as joint pain and swellings, skin alterations, difficulty in breathing, persistent coughing, fever, constant fatigue, influenza-like symptoms, diminished performance, heart rhythm disorders, weight loss, signs of paralysis, vision and hearing troubles, the doctor should be consulted. It might be necessary for him to exclude first other diseases before establishing a reliable diagnosis.


How does the disease develop?
The acute sarcoidosis (Löfgren syndrome) with “erythema nodosum” (bluish-red blotches on the extensor sides of the lower legs or arms) and enlarged hylislymphnodes on both sides can imply a spontaneous healing in a subsequent phase.

A slow development at the beginning, in particular if the affection involves several other organs, implies a chronic evolution. Concerning the lung, the affection can even cause fibrosis. However, even in case of a chronic evolution the disease may regress. Many patients suffer from pathological pushes. Therefore, regular evolution controls ought to be carried out by a specialist.

In almost every patient the progression of the disease can be stopped or at least considerably lowed down, if it is treated in time with cortisone, which is considered the best remedy.


The sarcoidosis treatment at Höchenschwand
Since the begin of the 1950s Höchenschwand has become a centre of sarcoidosis treatment, thanks to the sarcoidosis research, conducted for several decades by Prof. Dr. Wurm. In recent years thousands of sarcoidosis patients have been treated at Höchenschwand.

According to the scientific knowledge of today, sarcoidosis has to be considered a general disease affecting the whole body in the sense of an immunologically determined systemic “response disease”. Although its primary cause is still unknown, we know that it is neither a contagious disease nor a malignant disease. Often the sarcoidosis disappears without pharmaceutical treatment.

Since the original pathogenic agent enters the body through the respiratory system, the lung is primarily affected. However, any other organ can be concerned in a subsequent stage. The persistence of the disease lies between several months and several years.

The principle aim of the treatment consists in suppressing the excessive (hyperergic) reaction in form of the production of so called granulomas. If the affection requires a pharmaceutical intervention, the treatment with cortisone, a natural human hormone, ought to be taken into consideration. Today it is possible to avoid the collateral effects, which occurred in the early period of cortisone treatment, by an adequate, sarcoidosis–related choice, dosage and administration of the medical compound. Thus the still widespread fears are unfounded.
The application of drugs like “Imurek” or “Zytostatika” is confined to exceptional cases. There are no other medicaments for the treatment of sarcoidosis. Many of the pharmaceuticals used in the past have revealed inefficient.

The sarcoidosis treatment at Höchenschwand is not only characterized by a corticoid therapy adapted to sarcoidosis, but also by varied sustained physical activity according to a physical exercise scheme adapted to the individual physical ability, supposed to  prevent undesirable pharmaceutical effects. In contrast to the treatment at home or in a common hospital, Höchenschwand presents unique basics for rehabilitation given its special facilities, its geographical situation (“village near heaven”) and its beautiful landscape combined with its additional physical-balneological treatments and individual diets. Moreover there is the favourable impact of the healthy climate characterized thanks to the height of about 1000 metres by the absence of harmful and burdensome factors, such as pollutants, sultriness and fog, and by a favourable concomitance of healthy and stimulating factors (“bracing level 3”).

Given the therapeutic successes achieved in the course of several decades and the simultaneously gathered experience concerning sarcoidosis and other ophthalmological affections, Höchenschwand can justifiably pretend to be the German therapy centre (without rest insufficiency) for all forms of sarcoidosis but also for all respiratory and cardiovascular disorders. Concerning especially these pathologies, the physical exercise is a major part of the entire therapy according to the principle developed in recent years in the medical science.