Sarcoidosis is a disease that causes inflammation of the body’s tissues. Inflammation is a basic response of the body to injury and usually causes reddened skin, warmth, swelling, and pain. Inflammation from sarcoidosis is different. In sarcoidosis, the inflammation produces small lumps (also called nodules or granulomas) in the tissues.
Unfortunately, sarcoidosis of the lungs causes granulomas that can obstruct the smaller airways (air trapping). This places the diver with this condition at risk for pulmonary barotrauma (‘burst lung’) when diving with compressed air. On ascent, you might develop gas embolism or pneumothorax (lung collapse) and possible death from drowning or cerebral damage from bubbles in the arterial circulation.
Pulmonary Barotrauma from Sarcoidosis in a Chamber Dive
Here is a report of an accident that occurred in a recompression chamber (dry dive) and reported in the journal of Aviat Space Environ Med 1999; 70:594-7.
“An asymptomatic 46-yr-old male sustained an acute neurologic insult, appearing during the decompression phase of a 50-m dry hyperbaric chamber dive. The right hemisyndrome was most probably related to diving, since symptoms responded rapidly to the early commenced recompression therapy. Further diagnostics revealed a previously unknown pulmonary sarcoidosis with bilateral pulmonary opacities and pleural adhesions that might have predisposed to arterial gas embolism secondary to pulmonary barotrauma. This case may illustrate a potential risk of decompression illness even during dry chamber dives in patients suffering from asymptomatic pleuro-parenchymal pulmonary disease. The value of chest X-ray in the medical assessment of fitness to dive is therefore emphasized. “
Abnormalities of pulmonary sarcoidosis are present in 90-95% of the cases and remission (regression of symptoms and physical findings) occurs in about two thirds of the cases of sarcoidosis with pulmonary disease. Follow-up chest x-rays that show remission of the disease probably can allow return to diving after full respiratory assessment and one year of remission without recurrence of the disease. (in ‘The Sports Diving Medical’, by John Parker, MD)