sarcoidosis

Last reviewed 11/2023

Sarcoidosis is a multisystemic inflammatory disorder of unknown etiology characterized by the accumilation of non-caseating epithelioid granulomas in involved organs (1).

  • the disease may occur at any age but is usually present in adults under the age of 50 years with a peak in incidence between the 20 and 39 years of age (2)
  • any organ system can be involved but lung involvement dominate in most of patients (2)    
  • diagnosis is made when clinicoradiologic findings are supported with histological analysis of tissue samples for evidence of noncaseating epitheliod cell granulomas (3).

The course of the disease is variable:

  • acute sarcoidosis
    • usually follows a benign course
    • more commonly seen in young white adults
    • characterised by diffuse usually bilateral ankle swelling with or without erythema nodosum and bilateral hilar lymph node involvement
  • chronic and recurrent sarcoidosis,
    • affects elderly patients, more commonly the Afro-Caribbean population and may have multisystem involvement
    • lung infiltration may progress to pulmonary fibrosis
    • may be resistant to conventional treatment (4)

The clinical manifestations of sarcoidosis are diverse (4):

  • the accumulation of T-lymphocytes, mononuclear phagocytic cells and non-caseating granulomas occurs in involved organs. These granulomas may resolve spontaneously or lead to secondary fibrosis and permanent organ damage
  • sarcoidosis involves the lungs in over 90% of cases and commonly the lymphoreticular system, skin, eyes, muscles and joints. Less commonly other organs, including the heart, kidneys, brain and peripheral nervous system, may be clinically affected

Reference:

Related pages:

aetiology

epidemiology

pathogenesis of pulmonary sarcoidosis

clinical features

investigations

differential diagnosis

treatment

prognosis

Lofgren syndrome