Maybe You Have
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This page should actually be blank, since we are talking about a disease that is almost impossible to diagnose, has few effective treatments, and no definite cause. Yet you could have had it for years.

Perhaps your persistent cough prompted you to visit an emergency room. The doctor returns with a serious face after checking your X-rays, and explains your lungs show large dense masses -- possibly tuberculosis, or even cancer. Soon you will be plunged into a hellish workup that could involve CT-Scans, bronchoscopy, surgery and biopsies that show granulomas -- tiny balls of inflammatory cells -- have infiltrated the lymph nodes next to your heart. Further questioning may reveal painful lumps on your legs called eythema nodosum. Perhaps you have been plagued with joint pain, night sweats, eye inflammation or abnormal liver functions. Blood tests are inconclusive, cultures fail to find a cause of infection. Ultimately the diagnosis is made through biopsy of . . . your salivary gland. At last the thing is decided -- you have sardoidosis.

Your initial joy at finding out you don't have cancer or tuberculosis will soon fade to puzzlement as you struggle to understand what is actually wrong with you. The tiny inflammatory granulomas suggest an infection from a tuberculosis-like organism, but no germ has ever been isolated, and antibiotics are not effective. A family history may be present in 5% of patients, and African Americans are at threefold risk, yet certain groups such as Scandinavians also have high rates of illness. Is it the result of a gene mutation? Could it be an allergic reaction to pine pollen? Toxins such as smoke? Possibly an autoimmune syndrome? Exposure to beryllium? Research shows contradictory results.

After the diagnosis, you may receive a brief course of steroids -- or no treatment at all, making you wonder why you bothered visiting a doctor in the first place. Lingering symptoms become a part of daily life. Some cases may progress to death due to destruction of the lung, liver or brain, but the majority of cases gradually go away after a decade, leaving only calcified nodes on your X-ray to befuddle the next generation of doctors who take care of you.

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