What is the Difference Between Lupus and Sarcoidosis

Lupus and sarcoidosis are both autoimmune diseases affecting multiple organs.  Autoimmune disease occurs when the immune system mistakenly attacks normal cells due to a genetic mutation. There are nearly 100 types of autoimmune diseases that affect many parts in the body.

The key difference between lupus and sarcoidosis is their nature. Lupus has deposits of immune complexes that mainly affect multiple organs and tissues such as the heart, skin, nervous system, joints, kidneys, liver, lungs, and blood vessels, while sarcoidosis has deposits of inflammatory cells, forming nodules that mainly affect multiple organs and tissues such as liver, lungs, skin, eyes, brain, heart and blood.

CONTENTS

1. Overview and Key Difference
2. What is Lupus  
3. What is Sarcoidosis
4. Similarities – Lupus and Sarcoidosis
5. Lupus vs Sarcoidosis in Tabular Form
6. Summary – Lupus vs Sarcoidosis
7. FAQ – Lupus and Sarcoidosis

What is Lupus?

Lupus is an autoimmune disorder that causes inflammation, which can affect many different body systems, including the joints, skin, heart, kidneys, blood cells, brain, and lungs. Lupus is more common in women. Some potential triggers of lupus are sunlight, infections, and certain types of medications such as blood pressure medications, anti-seizure medications, and antibiotics. The signs and symptoms of lupus are fatigue, fever, joint pain, butterfly-shaped rash on the face, skin lesions that may worsen with sun exposure, fingers, and toes that turn white or blue, headaches, dry eyes, shortness of breath, chest pain, confusion, and memory loss.

Figure 01: Lupus

Lupus can be diagnosed through physical examination, complete blood count, erythrocyte sedimentation rate, kidney and liver assessment, urinalysis, antinuclear antibody test (ANA), chest X-ray, echocardiogram, and biopsy. Furthermore, treatment options for lupus may include medications such as NSAIDs, antimalarial drugs, corticosteroids, immunosuppressants, biologics, abatacept, anifrolumab, alternative medicine such as dehydroepiandrosterone (DHEA), fish oil, and acupuncture.

What is Sarcoidosis?

Sarcoidosis is an autoimmune condition that causes lumps or nodules called granulomas to form in multiple organs and tissues such as lungs, lymph nodes, skin, eyes, muscles, brain, liver, heart, and blood. Sarcoidosis affects those assigned female at birth (AFAB) slightly more than those assigned male at birth (AMAB).

The general symptoms of sarcoidosis are fever, fatigue, joint pain, muscle ache or weakness, night sweats, unexplained weight loss, swollen lymph nodes, kidney stones, cough, shortness of breath, wheezing, chest pain, eye pain, growths under the skin around scars and tattoos, irregular heartbeats, heart failure, weak or paralyzed facial muscles, headaches, and seizures.

Figure 02: Sarcoidosis

Sarcoidosis is usually diagnosed through physical examination, imaging (X-ray, CT scan, MRI), biopsy of suspected granuloma, endobronchial ultrasound-guided transbronchial fine needle aspiration (EBUS-TBNA), pulmonary function test, electrocardiogram, purified protein derivative test, and slit lamp examination. Furthermore, sarcoidosis is treated through medications such as corticosteroids, immunosuppressants, anti-tumor necrosis factor-alpha antibodies, and NSAIDs.

Similarities Between Lupus and Sarcoidosis

1. Lupus and sarcoidosis are both autoimmune diseases that affect multiple organs.
2. Both are due to the immune system affecting its own tissue.
3. Both are common in women.
4. They have periods of remission and flare-ups.
5. Both can be diagnosed through physical examination and imaging tests.
6. Both are mainly treated through surgeries.
7. They are treated with steroids.

Difference Between Lupus and Sarcoidosis

Definition

1. Lupus is an autoimmune disorder that has deposits of immune complexes.
2. Sarcoidosis is an autoimmune disorder that has deposits of inflammatory cells which form nodules.

Symptoms

1. A butterfly-shaped rash on the face, anemia, inflammation of the lining of the heart, pleuritic, accumulation of fluid in lungs, hemorrhage into the lungs, diffuse inflammation into lung tissue, kidney damage, seizures, psychosis, anxiety, confusion, and nerve disorders.
2. Progressive breathlessness, enlargement of lymph nodes, inflammation of layers of the eye called uveitis, damage to heart valves, anemia, and spleen enlargement, pain in peripheral nerves, patchy hair fall, and dry mouth.

Risk Factors

1. Sex (women affected more), age (more common in ages 15 to 45), and race (African Americans, Hispanics, and Asian Americans).
2. Sex (women affected more), age (more common in age 25 to 40) and more common in Black people than white people.

Diagnosis

1. Physical examination, blood test, urinalysis, antinuclear antibody test (ANA), chest X-ray, echocardiogram, and biopsy.
2. Physical examination, chest X-ray, MRI, ultrasound, biopsy, lung function test, eye test, electrocardiogram (EKG), and tuberculin skin test.

Treatment

1. Anti-inflammatory medicines like ibuprofen, hydroxychloroquine for fatigue and skin and joint problems, steroid tablets, injections and creams for kidney inflammation and rashes, Immunosuppressant or biological medicines.
2. Corticosteroids, immunosuppressants, anti-tumor necrosis factor-alpha antibodies, antimalarial drugs, NSAIDs, physical therapy, pulmonary rehabilitation, implantation of a cardiac pacemaker or defibrillator for heart rhythm problems, and organ transplantation.

The following table summarizes the difference between lupus and sarcoidosis.

Summary – Lupus vs Sarcoidosis

Lupus and sarcoidosis are both autoimmune diseases affecting multiple organs. Lupus is an autoimmune disorder resulting in inflammation, which causes widespread deposition of immune complexes in affected organs and tissues while sarcoidosis is an autoimmune disorder resulting in inflammation that causes granulomas to develop in affected organs and tissues. This summarizes the difference between lupus and sarcoidosis.

FAQ: Lupus and Sarcoidosis

1. What is the main cause of lupus?

• Lupus is a complex autoimmune disease in which the body’s immune system attacks a person’s tissues and organs. The triggers of lupus include sun light exposure, infections and certain types of medications such as blood pressure medications, anti-seizure medications, and antibiotics.

2. What are the main symptoms of lupus?

• The main symptoms of lupus are extreme fatigue, loss of appetite, low-grade fever, weight loss, headaches, butterfly rash on the face, malaise, seizure, and anxiety.

3. Is lupus treatable?

• Lupus can’t be cured completely. Doctors work on managing the symptoms. The treatment options may include medicines such as NSAIDs, antimalarial drugs, corticosteroids, immunosuppressants, biologics, abatacept, anifrolumab, dehydroepiandrosterone (DHEA), fish oil and acupuncture.

4. How to diagnose sarcoidosis?

• Diagnosis methods of sarcoidosis include physical examination, biopsy of the skin, lymph nodes, lungs, or other affected organs, bronchoscopy to get the biopsy sample from the lungs or lymph nodes in the chest, blood tests, eye test, imaging test ( X-ray, MRI and ultrasound), electrocardiogram (EKG) tuberculin skin test.

5. Can I live a normal life with sarcoidosis?

• Sarcoidosis cannot be cured completely. There are periods of remission and flare-ups. However, people who develop sarcoidosis can go on to live normal lives with treatment options such as medications such as corticosteroids, immunosuppressants, anti tumor necrosis factor alpha antibodies and NSAIDs.

Reference:

1. “Lupus.” NHS Choices, NHS.
2. “Sarcoidosis: Symptoms, Stages, Causes, and Treatment.” WebMD.

Image Courtesy:

1. “Lupus pernio 01” By M. Sand, D. Sand, C. Thrandorf, V. Paech, P. Altmeyer, F. G. Bechara – M. Sand, D. Sand, C. Thrandorf, V. Paech, P. Altmeyer, F. G. Bechara: Cutaneous lesions of the nose. In: Head & face medicine Band 6, 2010, S. 7, ISSN 1746-160X. doi:10.1186/1746-160X-6-7. PMID 20525327.. (Review). Open Access (CC BY 2.0) via Commons Wikimedia
2. “Cutaneous findings in systemic sarcoidosis” By Nowack et al. BMC Dermatology 2002 2:15 doi:10.1186/1471-5945-2-15 Biomedical Center (CC BY-SA 2.0) via Commons Wikimedia

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