Sarcoidosis - case report

Sarcoidosis is a multisystem granulomatous disorder of unknown cause affecting most frequently in young adults with bilateral hilar adenopathy and pulmonary infiltrates. Although the disease spontaneously resolves in many patients, may also evolve to a progressive and severe outcome. The lack of markers of activity and prognosis, and the lack of treatment protocols, raise many doubts on the decision to treat and to provide optimum therapy to the patient. We present a 32 year old female patient, who has been followed for 10 years with a diagnosis of sarcoidosis, initially with lung and lymph node involvement. Despite the good initial response to steroid therapy, the disease appears to be steroid-dependent and progressive, with multisystemic involvement. The steroids side-effects and the inefficiency of azathioprine as “steroid sparing agent” contribute to the difficulty in monitoring the progression of the disease. Given the unfavorable progression of sarcoidosis and the desire expressed by the patient to become pregnant, we present this case as a pattern of the challenges posed by this disease.