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Difference between Lupus and Sarcoidosis

Lupus vs sarcoidosis

We are in an age where infections have been curtailed or eradicated to no longer being a scare. Nature has still found a way to keep the human population under check. Auto-immune disease is a new type of disease that has been identified in the recent decades and is growing steadily. Disorders in which the body’s defence system starts attacking its own cells due to a genetic mutation are termed as auto-immune disorders. Examples are Rheumatoid arthritis, sarcoidosis, systemic lupus erythematosus, Crohn’s disease, Ulcerative colitis, etc.

Systemic Lupus Erythematosus (SLE), commonly called as lupus, is one such auto-immune disease that has steadily increased in prevalence in the past decade or so. It affects multiple organs and tissues at the same time like heart, skin, joints, kidneys, nervous system, liver, lungs and blood vessels. Sarcoidosis is another auto-immune disease where inflammatory cells collect and form granulomas (nodules) in various tissues all over the body.

Lupus and sarcoidosis are known for their intermittent nature of exacerbations. There are periods when the patient is free of symptoms (remission) followed by severe flare-ups (exacerbations). There is no fixed duration of either the remission or exacerbation. Sarcoidosis is thought to be a reaction to an erstwhile infection which continues despite the infection being over. Genetics play an important role in both.

Symptoms of lupus can be seen in all the systems it affects. In the skin we can see disc-shaped rashes, butterfly rash on nose and cheeks, hairfall, ulcers in mouth/nose/ vagina. It produces joint pains of the small joints of hands like knuckles, wrists with swelling and redness. Deformities of joints are rare. It causes anemia and lowers platelet and white blood cell count of blood. It may cause inflammation of the linings of the heart like pericarditis, endocarditis or myocarditis. In the lungs it can cause inflammation of lungs’ covering called pleuritis, accumulation of fluid in lungs called effusion, haemorrhage into lungs, and diffuse inflammation of lung tissue. It can damage the kidneys leading to loss of protein and blood in urine. It can lead to kidney failure in the long term. It can also cause neuropsychiatric symptoms like seizures, psychosis, anxiety, confusion and nerve disorders.

Sarcoidosis produces symptoms wherever the nodules of the cells are formed. Liver, lungs, skin, eyes, brain, heart and blood may be affected. Lungs are affected most often having nodules and progressive breathlessness due to widespread inflammation within lung tissue. Enlargement of lymph nodes, inflammation of layers of eye called uveitis, damage to heart valves, anemia and spleen enlargement, pain in peripheral nerves, patchy hair fall and dry mouth are all manifestations from the other systems it affects. Joints and kidneys are rarely affected unlike lupus.
Diagnosis of lupus is by identifying antibodies called Anti-nuclear antibody (ANA) in the blood sample. There is a WHO criterion of 11 points including signs, symptoms and blood tests that is needed to confirm SLE. Sarcoidosis is identified often after excluding all other possible conditions. Chest x-ray, chest CT scan, tissue samples from symptomatic organs are commonly needed to arrive at a diagnosis.

There is no cure for lupus. Treatment aims at palliation and improving quality of life. Painkillers are given for joint pains. Dietary deficiencies are corrected by nutritional supplements. Steroids are often the choice of treatment to keep the exacerbations under check and prevent worsening of the disease. Symptomatic treatment is given for all other symptoms as well. Almost 30- 70% patients of sarcoidosis need no treatment. Symptoms when seen are handled using steroids and immunosuppressant like methrotrexate.

Take home pointers:

Lupus and sarcoidosis are both auto-immune diseases affecting multiple organs. Lupus has deposits of immune complexes while sarcoidosis has deposits of inflammatory cells that form nodules in organs.
Both are incurable and have periods of remission and flare-ups.
Both are treated with steroids.

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  1. Nature has found away? Seriously??? How about all the damage done by consuming GMO’s, Aspartame, Splenda, High Fructose Corn Syrup?

    • I was diagnosed with sarcoidosis about eight years ago it’s to the point where I Can’t get out the bed I have joint pain in my ankles my knees my hips my elbow my shoulders my wrist my lungs hurt so bad I coughed all the time I cough to throw up I’ve been on steroids for about three years don’t find it’s Attacks in my eyes my brain my heart and my lungs

  2. I think that your wrong about sarcoidosis in not affecting the joints I have horrible joint pain and my nodules subside in the lungs I think that alot more research should be done about sarcoidosis and how it really is a horrible condition the people who do have symptoms are suffering horribly and no one even knows you I had to stop my life style as I knew it double in the amount of work at my jobs to pay for all the meds and treatment and still nothing works I think that more people should be aware that it’s not just a minor things that it’s real and it can happen to anyone it should be taken seriously

    • That’s the same thing I gathered from it. Its DEFINITELY incorrect about the joint pain, Like you said. I feel aweful quite frequently. The fact that nobody knows where it comes from nor why people get it, but that its of genetic origin? This article has rattled my nerves. I also have Kyphosis and a doctor looked me in my eyes and told me that my shoulder wasn’t hurting that badly because of my Kyphosis. I do a lil research and sire enough, I find an article full of people saying practically, the exact same thing that the pain is severe and nothing they try helps ease it any.

    • I too have sarcoids of the lungs type 2 I’m going through a lot I’ve now been diagnosed with diabetes type 2, degenerative disc disease (I just had a cervical fusion done 11-18-2016), high blood pressure, colitis ( which I have to see the GI Dr tomorrow to have an EGD down to make sure it’s not chrons or ulcerative) they say my thyroids need to come out it’s just 1 thing after another and I’m fighting disability my body is full of inflammation it hurts in my joints sometimes to walk they need more research on this debilitating disease they told me i was in remission because my lungs were OK mean while other parts of my body is breaking down that’s very deceptive to label sarcoids when it can attack any part of your body it wants it has attacked my eyes before and I’ve been to 2 rheumatologist with no help i pray they treat sarcoids like lupus we have the same symptoms and treated with the same drug’s it’s very overwhelming.

    • You are exactly right I have horrible pain, have been in heart and kidney failure several times and severe pneumonia. I hope more research is done and they find something besides horrible steroids like prednisone to treat it. Last summer I was on it for a few months and gained over 30 lbs. I’m just now starting to lose it.

  3. OK,
    This was a very helpful article. I’m being tested for both at this moment.

    One more point that I have found is:
    Sarcoidosis ” usually” is paired with other autoimmune diseases.

    Excellent article.

    • @J Davis – I agree with you. I seem to have symptoms of sarcoidosis and some other autoimmune disorder of which I am not sure what.

      @keep our freedoms – I agree wholeheartedly.

      To Samantha – I too have joint pain – mostly in knees. But I have other symptoms such a pain in left side middle to upper region. Sometimes when I breathe I have pain in side or upper back. I have discoloration in my sides. I have a body heat problem that started April 2016 that spread to my back, and is in almost all parts of my body. It is there all the time, it never leaves. Whatever I lie or sit on gets hot underneath. I have to keep turning in bed to get relief. I have thigh and knee pain also. I have very bad stiffness so bad that sometimes I can barely walk. The stiffness is such that my legs feel like I’m lifting heavy weights. I have had that in my entire life before this year! When I used to walk long distances 1 or more miles. I can barely make it to a nearby store (5 to 10 minute walk). The fatigue from the leg problems is such that I am forced to keep sitting down. I have redness in the legs (knees, thighs) that started around October, first the right leg and then to the left a few weeks ago (perhaps November? I forget). I keep “presenting” with new symptoms every few days since the 13th of June this past year 2016. Plus I have femoral nerve pain also which I never know when the right thigh will start with those what I call “jumpy spasms” or shooting pains. I hope all who suffer from our own individual symptoms get better and have a good quality of life.

  4. Correction on my last post: I meant to say I have never in my entire life had these symptoms until this year. (I thought I had typed the word “never” but it did not come up in my previous post)

  5. Sarcoidosis is no longer classified as an auto-immune disease, although it has some similarities, and those diagnosed with sarcoidosis often have other auto-immune diseases as well.

    Sarcoidosis has no known cause and no known cure. It is an inflammatory disease that is characterized by a hyper-active immune system.

    Sarcoidosis is a chronic disease that affects multiple systems in the body, from the eyes to the lungs to the brain. It is characterized by the buildup of immune system cells in organs that form small clusters called granulomas. These granulomas can interfere with organ function.

    You can look at the Foundation for Sarcoidosis Research for a good definition and more information. http://www.stopsarcoidosis.org

    • I have sarcoidsis and it started on my spine which I also have neurosarcoidsis I have weakness on my right side my eyes have been affected I have to have a pacemaker because it has affected my heart. All the steroids has messed up my stomach.

      • My husband is having problems with sarcoidosis around his heart. Do you know if thete is snything thst could help him? Im scared.

  6. I’m in the process of being rested for this horrible disease that I had never even heard of, waiting for the results of a biopsy I did to a growth on my arm of which I thought was an ingrown hair. The CT scan confirmed Sarcoidosis. I have to say that stating from the coughing and the dreadful fatigue, the joint pain from my feet to my knees and hips is unbearable, there are days I want to cry it’s so unbearable to even try walk.

  7. I have walked with sarcoidosis since before 1972. In 1994 Skin biopsy showed lupus in my skin. It was a few years before I had to surrender and begin steroids et al. Each of us must walk our road, I may not have the same symptoms as you, but I can empathize with your struggle. Each of the symptoms you mention I have seen. I am at the point with the Drs that I now say “ we cannot fix it so I just want to keep walking long as I remain here”

  8. My father he is diabetic and suddenly he got some skin rashes which disappear in some time.but he left with mild fever 99degree on daily basis from the last one year.He had skin biopsy, pat scan, bronchoscopy and ANA test…and finally he is diagnosed with Lupus . Doctor started prednisolone and HCQs with vit D and Calcium.But the thing is due to steroids his fever has gone but sugar level is not controlled for that he started insulin.But his hemoglobin also decreased

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