Sarcoidosis

Sarcoidosis is a multisystem inflammatory disease of unknown etiology that manifests as non caseating granulomas, predominantly in the lungs and intrathoracic lymph nodes.

Signs and symptoms

The presentation in sarcoidosis varies with the extent and severity of organ involvement, Common presentation is as follows

 

  • Asymptomatic (incidentally detected on chest imaging): Approximately 5% of cases
  • Systemic complaints (fever, anorexia): 45% of cases
  • Pulmonary complaints (dyspnea on exertion, cough, chest pain, and hemoptysis [rare]): 50% of cases
  • Löfgren syndrome (fever, bilateral hilar lymphadenopathy, and polyarthralgias)

 

Diagnosis

Diagnosis requires biopsy in most cases. Endobronchial biopsy via bronchoscopy is often done. The yield is high; results may be positive even in patients with normal chest radiographs. The central histologic finding is the presence of noncaseating granulomas with special stains negative for fungus and mycobacteria.

Management

Nonsteroidal anti-inflammatory drugs (NSAIDs) are indicated for the treatment of arthralgias and other rheumatic complaints

For extrapulmonarysarcoidosis involving such critical organs as the heart, liver, eyes, kidneys, or central nervous system, corticosteroid therapy is indicated.Topical corticosteroids are effective for ocular disease. For pulmonary disease, prednisone is generally given daily and then tapered over a 6-month course.

Some patients may require other medications based on disease response and complications

Eg Methotrexate, Azathioprine,Hydroxychloroquine,etc