Between Amyloidosis and Sarcoidosis the top 9 difference

Nov 20, 2023

Sarcoidosis and Amyloidosis are both medical conditions that affect different organ systems. Both conditions share similarities with respect to the potential organ involvement, systemic impact, and clinical presentation.

However, they are different in their underlying causes and pathophysiological mechanisms. It is important to understand the differences between these conditions in order to make an accurate diagnosis and choose the right treatment. We will introduce Amyloidosis, and Sarcoidosis briefly in this overview before diving deeper into their differences.

Brief overview of Amyloidosis

Amyloidosis, a rare group of complex disorders, is characterized by an abnormal accumulation of amyloid protein in organs and tissues all over the body. Amyloid proteins that are normally soluble and functional misfold into fibrils when amyloidosis occurs. These fibrils may accumulate in various organs and disrupt their normal function.

The key points about Amyloidosis:

  1. Types: There is a wide range of amyloidosis types, including the primary (AL), second (AA), hereditary forms (ATTR), as well as localized and other forms. Each type has different clinical characteristics and underlying causes.
  2. Organ involvement: Amyloid deposits may affect organs such as the liver, heart, kidneys, and nervous system.
  3. Clinical Presentation: The symptoms of amyloidosis can vary greatly depending on which organs are affected. Common symptoms include fatigue, weight gain, edema, and shortness of breath.
  4. Diagnosis: Diagnosis is usually a combination of clinical evaluation, imaging tests, laboratory testing, and tissue biopsies to identify amyloid deposits.
  5. Treatment: Treatment options for amyloidosis are dependent on the organ involved and its type. Treatments can include stem cell transplantation and chemotherapy to treat symptoms and complications.
Figure 01: Amyloidosis

Amyloidosis can be a life-threatening and complex condition. It requires specialized medical management and evaluation tailored to each patient’s specific needs.

Definition and characteristics

Amyloidosis, a rare group of complex disorders, is characterized by an abnormal accumulation of amyloid protein in organs and tissues all over the body. Amyloid proteins that are normally soluble and functional misfold into fibrils when amyloidosis occurs. These fibrils may accumulate in various organs and disrupt their normal function.

The key characteristics of amyloidosis are:

  1. Amyloid Fibril Formation: Amyloidosis manifests itself by the formation of insoluble fibrils. These fibrils are made up of misfolded proteins that form beta-sheet structures. They are resistant to degradation.
  2. Organ involvement: Amyloid deposits may affect many organs and tissues including the skin, digestive tract, liver, heart, kidneys, and nervous system. Organs can be affected differently depending on the type.
  3. Amyloidosis Types: There is a wide variety of amyloidosis types, each with its own underlying cause and abnormal protein. There are four main types of amyloidosis: primary (AL), secondary (AA), hereditary amyloidosis (ATTR), and localized.
  4. Clinical Presentation: The symptoms of amyloidosis depend on the organs affected and the extent of the amyloid deposition. Common symptoms include fatigue, weight gain, edema, shortness of breath, neuropathy, gastrointestinal disturbances, and cardiac complications.
  5. Diagnostic Challenges: The diagnosis of amyloidosis is often a combination of clinical evaluation, imaging tests (such as ultrasound and imaging scans), lab tests (such a serum and urine protein analysis), and tissue biopsies to identify amyloid deposits.
  6. Treatment Options: Treatment options depend on the organ involved and its type. Treatments can include stem cell transplantation and chemotherapy to treat symptoms and complications.

Amyloidosis can be a life-threatening and complex condition. It requires medical management and evaluation tailored to each patient’s specific needs. Amyloidosis patients need to receive early diagnosis and treatment.

Prevalence and affected organs

Amyloidosis Prevalence and Organs Affected:

  1. Prevalence: The prevalence of Amyloidosis depends on its type and geographical location. It is considered to be a rare condition. Here are some statistics on the prevalence of each type:
    • Primary Amyloidosis: The most common form of amyloidosis, it affects 8-12 people per million annually.
    • Amyloidosis Secondary (AA): AA amyloidosis occurs less frequently and is often a complication from chronic inflammatory diseases, such as arthritis or inflammatory colitis.
    • Amyloidosis (ATTR) Hereditary: AtTR amyloidosis is found in certain geographic regions such as Portugal and Sweden. Some ethnic groups are more prone to it.
  1. Organs Affected: Amyloid deposition can accumulate in different organs and tissues of the body. Organs can be affected differently depending on the type and severity of amyloidosis. Organs that are commonly affected include:
    • Heart: Cardiac involvement can cause heart failure or arrhythmias. This is especially common in AL amyloidosis.
    • Kidneys: Amyloid deposits can cause proteinuria, nephrotic Syndrome, and kidney failure.
    • Nervous system: Although peripheral neuropathy is common, central nervous system involvement may also be present, resulting in cognitive impairment.
    • Gastrointestinal Trace: Amyloidosis affects the digestive system and can cause symptoms such as diarrhea, malabsorption, or liver enlargement.
    • Liver Hepatic involvement can be seen in amyloidosis AA, but it is also possible in other forms.
    • Skin: Amyloid deposition can cause skin lesions or bruises.
    • Spleen: In some cases, the spleen can be enlarged (splenomegaly).
    • Lungs: Pulmonary involvement occurs less frequently but can cause respiratory symptoms.
    • Joints: Joints may be affected causing stiffness and pain.

Even within the same amyloidosis type, the pattern of organ involvement may vary from person to person. The distribution of amyloid proteins in the body and their type are crucial factors that determine which organs will be affected by the disease. A personalized treatment plan and early diagnosis are key to managing amyloidosis.

A Brief Overview of Sarcoidosis

Sarcoidosis, a rare inflammatory condition, is characterized by the presence of granulomas (small clumps containing inflammatory cells) in different organs and tissues. These granulomas may affect the normal function and structure of affected organs. Sarcoidosis is most common in the lungs and lymph nodes but can affect any organ system.

Sarcoidosis: Key Points

  1. Etiology: Although the exact cause of Sarcoidosis is unknown, it is thought to be caused by an abnormal immune reaction to an unknown trigger in genetically susceptible individuals.
  2. Granuloma Form: Sarcoidosis manifests as granulomas (macrophages), which are immune cells that form in response to inflammation. These granulomas are found in the affected organs.
  3. Involvement of Organs: Sarcoidosis affects multiple organs.The most commonly affected organ is the lungs. Lymph nodes, the skin, the eyes, and even the heart are frequently affected. Virtually any organ can be affected, including the liver and spleen.
  4. Clinical presentation: The clinical manifestation of sarcoidosis depends on the organs affected. Common symptoms are cough, shortness of breath, fatigue, skin nodules or rashes, swollen nodes, and eye problems. Many people with sarcoidosis have no symptoms and are only diagnosed by chance through routine medical exams or X-rays of the chest.
  5. Diagnosis: The diagnosis is usually based on clinical findings, imaging tests (such as X-rays of the chest or CT scans), and biopsies (often of the lymph nodes or lung). The characteristic granulomas are visible in biopsies.
  6. Treatment: Sarcoidosis can be a heterogeneous condition, and it is not necessary to treat all cases. The treatment is reserved for those with severe symptoms or organ involvement. Inflammation is treated with corticosteroids, but in severe cases other immunosuppressive drugs may be prescribed.
  7. The prognosis: varies. Some people have a self-limiting form of sarcoidosis, in which symptoms improve over time or disappear without treatment. For some people, sarcoidosis may become chronic, leading to organ dysfunction or damage. Those with severe or persistent disease require regular monitoring and medical treatment.
Figure 02: Sarcoidosis

Sarcoidosis can present differently for each individual. The best outcome for those with sarcoidosis is to ensure that they receive the right diagnosis and treatment, which often involves a team.

Prevalence and affected organs

Sarcoidosis and its Affected Organs:

  1. Prevalence: Sarcoidosis can be a rare disease. However, its prevalence varies by ethnicity and geographic area. It is estimated that in the United States, there are between 10 and 40 cases for every 100,000 people. It is most commonly diagnosed among people of African or Scandinavian descent. This disease is more common in middle-aged and younger adults.
  2. Organs Affected: Sarcoidosis affects a variety of organs and tissues in the body. Organs that are commonly affected include:
    • Lungs: Pulmonary involvement is the most common symptom of sarcoidosis. This can be manifested as chest pain, coughing, shortness of breath, or a nonproductive, dry cough. In some cases, lung function can be severely impaired.
    • Inflamed Lymph Nodes: This is a common manifestation. This is one of the first signs of sarcoidosis.
    • Skin: The skin can be affected by a variety of dermatological manifestations including skin rashes or nodules (usually on the legs) or erythema Nodosum.
    • Ocular Sarcoidosis: can cause uveitis, redness, pain and blurred sight. Eye involvement is severe and may require specialized treatment.
    • Heart: Cardiac Sarcoidosis: This less common condition can cause heart rhythm problems, heart failure or even sudden death.
    • Nervous system: Neurological involvement may cause headaches, facial weakness, changes in vision, and cognitive impairment.
    • Spleen and Liver: The liver and spleen can be affected, without causing any symptoms. However, blood tests and imaging may reveal the condition.
    • Joints; Joint swelling and pain can be experienced by some people.
    • Kidneys: Sarcoidosis, although less common, can affect the kidneys and cause kidney stones or impaired renal function.
    • Muscles: Muscle involvement can result in pain or weakness.
    • Bones: In rare cases, sarcoidosis can affect bones, causing bone pain or deformities.

The severity of the disease and the organs that are affected can vary greatly among people with sarcoidosis. The disease’s course can vary from mild self-limiting disease to chronic progressive disease that may cause organ damage.

For sarcoidosis to be managed and complications avoided, it is important to have a proper diagnosis and treatment. This may include corticosteroids or other immunosuppressive drugs.

Amyloidosis and Sarcoidosis in the tabular form

Here is a tabular comparison between Amyloidosis and Sarcoidosis:

Aspect Amyloidosis Sarcoidosis
Definition This rare group of disorders is characterized by the abnormal accumulation of amyloid proteins in various organs and tissues. Rare inflammatory disease is characterized by the formation of granulomas in multiple organs and tissues.
Etiology Various types with different underlying causes, including primary (AL), secondary (AA), hereditary (ATTR), and localized forms. Unknown, but believed to involve an abnormal immune response to an unknown trigger in genetically susceptible individuals.
Pathophysiology Formation and deposition of misfolded amyloid proteins disrupt organ function. Formation of granulomas (small clumps of inflammatory cells) in affected organs, leading to inflammation and organ dysfunction.
Prevalence Rare, with varying prevalence depending on the type. Rare, estimated at 10-40 cases per 100,000 people in the United States.
Common Organs Affected Heart, kidneys, nervous system, gastrointestinal tract, liver, skin, lungs. Lungs, lymph nodes, skin, eyes, heart, nervous system, liver, spleen, joints, muscles, bones.
Clinical Presentation Variable, depending on the organs affected. Common symptoms include fatigue, weight loss, edema, shortness of breath, neuropathy, and gastrointestinal problems. Variable, ranging from cough, shortness of breath, and chest pain to skin rashes, eye inflammation, and heart rhythm disturbances.
Diagnostic Methods Imaging techniques (e.g., X-ray, CT scans), laboratory tests (serum and urine protein studies), and biopsy. Clinical evaluation, imaging studies (e.g., X-ray, CT scans), blood tests, and tissue biopsy (commonly lung or lymph node) to identify granulomas.
Treatment Treatment varies based on the type and extent of organ involvement. Option may include chemotherapy, stem cell transplantation and supportive care services. Treatment is reserved for individuals with significant symptoms or organ involvement. Corticosteroids are often used to reduce inflammation, and other immunosuppressive drugs may be considered.
Prognosis Variable, depending on the type and individual response to treatment. Some types may have a poor prognosis, while others can be managed effectively. Variable, ranging from self-limiting cases with a good prognosis to chronic, progressive disease with potential organ damage. Regular monitoring is essential.

Note that the symptoms of both diseases are diverse and can vary from person to person. The diagnosis and treatment should be tailored to each patient’s needs and severity.

Importance of distinguishing between the two diseases

It is important to distinguish between Amyloidosis (a type of cancer) and Sarcoidosis for several reasons:

  1. Treatment selection: The treatment methods for these two conditions are very different. Amyloidosis requires specific treatments such as stem cell transplantation or chemotherapy, whereas Sarcoidosis can be managed using corticosteroids and immunosuppressive drugs. Correct diagnosis can improve the quality of life and outcomes for patients.
  2. Disease Course and Prognosis: Amyloidosis, Sarcoidosis, and other diseases have different disease courses and prognoses. Early intervention is crucial for Amyloidosis, which can be fatal. Sarcoidosis, on the other hand, can resolve spontaneously or may be a chronic disease with fluctuating severity. Healthcare providers can make more accurate prognostications when they know which disease the patient has.
  3. Follow-Up: Regular monitoring of both diseases is important, but the types and frequency of tests needed differ. Amyloidosis sufferers often require specialized assessments in order to monitor organ involvement and response to treatment. Sarcoidosis monitoring is focused on the disease activity and potential complications. It is important to ensure that patients are given the right follow-up treatment.
  4. Preventing Complications: Both diseases can cause organ damage if not treated. Amyloidosis can be treated early to prevent irreversible organ damage, such as kidney and heart failure. Sarcoidosis can be managed to reduce the risk of severe complications such as heart rhythm disorders or severe lung diseases.
  5. Avoiding Non-Necessary Treatments: Misdiagnosis may lead to unnecessary treatment and side effects. Amyloidosis patients may be worsened by immunosuppressive medication. Sarcoidosis can also progress if it is not treated properly.
  6. Research and Drug Development: Accurate diagnoses are crucial for clinical studies and research. By separating the two conditions, it is possible to ensure that the participants in clinical trials represent the condition being studied. This will facilitate the development of better treatments.
  7. Patient education and support: Knowledge of the disease specifically helps patients to understand their condition, treatment options, and prognosis. This helps them make informed decisions, and stick to their treatment plan. Patients and their families can receive tailored support from groups and resources that are available for each condition.

It is important to distinguish between Amyloidosis (a type of cancer) and Sarcoidosis (a form of sarcoidosis) for the purpose of determining prognosis, preventing complications, and ensuring appropriate treatment. This ensures patients receive the best care possible and that research is focused on the right disease entities.

Treatment and Management

The distinct nature of Amyloidosis and sarcoidosis, and their treatment and management differs significantly. Here are some general strategies for treating and managing each condition.

Treatment and Management of Amyloidosis:

  1. Type: It is important to accurately diagnose the type of Amyloidosis because treatment plans are dependent on the cause of the disease and the extent of organ damage.
  2. Address the Cause:
    • Primary Amyloidosis: Treatment usually involves chemotherapy, stem-cell transplantation, and targeted therapies in order to reduce abnormal protein production.
    • Amyloidosis Secondary (AA): The primary focus is to manage the chronic inflammation that underlies this condition.
  1. Supportive care
    • It is important to manage symptoms and complications. This can include medication for heart, kidney, or gastrointestinal symptoms.
    • Fluid management is important to avoid dehydration, kidney damage, and other complications.
  1. Organ-Specific Interventions:
    • Cardiac Amyloidosis: Heart medications such as diuretics and beta-blockers may be prescribed. Advanced cases may require heart transplant evaluation.
    • Renal Amyloidosis: Monitoring and management of kidney function including dialysis and kidney transplantation.
  1. Regular Monitoring: Routine follow-up appointments with specialists to evaluate disease progression and treatment responses.
  2. Support for Patients: By providing patients with support groups and educational resources, they can better manage their conditions and deal with the impact it has on their lives.

Sarcoidosis Treatment:

  1. Assess the Disease Severity: Treatment for Sarcoidosis is based on the severity and extent of organ involvement. Not all patients need treatment.
  2. Corticosteroids: Are commonly used to reduce inflammation. Prednisone, a commonly prescribed drug, is often prescribed. The dose and duration are determined by the patient’s response to treatment and disease progression.
  3. Immunosuppressive drugs: In severe or refractory Sarcoidosis cases, additional immunosuppressive medication such as methotrexate or azathioprine or biologics can be considered.
  4. Symptom management:
    • Pain relievers that work for muscle and joint pain.
    • Skin rashes and eye inflammation can be treated with medications.
    • Treatment of specific symptoms or complications such as shortness of breath, and cardiac involvement.
  1. Monitoring:
    • Follow-up appointments are necessary to monitor disease activity and response to treatment.
    • Imaging studies (e.g. X-rays or CT scans) are used to monitor organ involvement.
  1. Lifestyle management:
    • Avoid triggers and environmental factors that can exacerbate symptoms.
    • Quitting smoking is good for your lungs.
    • The improvement of lung function through pulmonary rehabilitation.
  1. Patient education: Provide patients with information on their condition, possible complications, and the importance of medication compliance.
  2. Supportive care: Support and counseling groups for patients who are struggling with physical and emotional symptoms of their disease.

The management of Amyloidosis or Sarcoidosis must be tailored to each patient’s specific needs and disease characteristics. For comprehensive management, multidisciplinary care may be needed involving specialists from cardiology, renal disease, pulmonology, and rheumatology. Research and advancements in treatment continue to influence the management of these diseases.

Prognosis and Outlook

Amyloidosis, Sarcoidosis, and their prognosis are affected by a variety of factors. These include the type of disease, the extent to which organs are involved, the overall health, and the response to treatment. Here is a general overview of the prognosis for each condition.

Amyloidosis Outlook and Prognosis:

  1. Primary (AL) Amyloidosis:
    • The prognosis is not always accurate but it’s usually guarded for the poor.
    • Early diagnosis and prompt treatments can improve outcomes.
    • Some patients may be able to achieve long-term remission with stem cell transplantation.
    • Heart transplants are considered for advanced cases of cardiac involvement.
  1. Secondary (AA) Amyloidosis:
    • The prognosis is dependent on the chronic inflammation that underlies it.
    • The underlying cause of the disease can be treated to stop or reverse amyloid formation.
    • Organ damage can be prevented by a prompt diagnosis and treatment.
  1. Hereditary (ATTR) Amyloidosis:
    • The prognosis depends on the mutation type and organ involved.
    • Other forms can cause organ failure or significant disability.
    • In some cases, the prognosis can be improved by using targeted therapies or gene-silencing drugs.
  1. Localized Amyloidosis:
    • The prognosis for localized forms is usually favorable as they do not typically affect multiple organs and cause systemic symptoms.
    • The removal of localized deposits can be therapeutic.

Amyloidosis management requires regular monitoring and follow-up since early detection of disease progression can lead to more efficient interventions.

Sarcoidosis Outlook and Prognosis:

  1. Self-Limiting Cases:
    • Sarcoidosis can be self-limiting in some individuals, meaning that the disease will spontaneously resolve without treatment.
    • In these cases, the prognosis for long-term consequences is minimal.
  1. Chronic Disease:
    • The outlook for individuals with chronic or progressing Sarcoidosis depends on the severity and extent of organ involvement.
    • The use of corticosteroids and other immunosuppressive medications can be used to manage symptoms and avoid complications.
    • It is important to monitor the patient regularly, since the disease can have unpredictable symptoms, including periods of remission or relapse.
  1. Cardiac Sarcoidosis:
    • Cardiac involvement may have a more cautious prognosis, and require ongoing management including medication and device therapy.
    • For better outcomes, it is important to get a diagnosis early and receive the appropriate treatment.
  1. Lung Transplant:
    • Lung transplantation is an option for severe cases of pulmonary Sarcoidosis that do not respond well to treatment.

Sarcoidosis has a wide range of prognoses, from remissions to chronic diseases with high morbidity. For the best management of this condition and to prevent complications, timely diagnosis, appropriate treatments, and regular follow-up are crucial. To optimize care, patients should work closely together with their healthcare team to monitor their disease and optimize their treatment.


Amyloidosis, Sarcoidosis, and other medical conditions are distinct and have unique diagnostic methods, treatment strategies, and characteristics.

It is important to distinguish between these two diseases for an accurate diagnosis, and a tailored treatment plan that improves patient outcomes and their quality of life. The ongoing management of complex conditions requires regular monitoring and multidisciplinary treatment.