SYSTEMIC DISEASE | Sarcoidosis

Sarcoidosis is a multisystem disorder of unknown cause(s) most commonly affecting young adults, and frequently presenting with hilar lymphadenopathy, pulmonary infiltration, and ocular and skin lesions. The diagnosis is established most securely when well-recognized clinicoradiographic findings are supported by histological evidence of widespread noncaseating epithelioid cell granulomas in more than one system. Because of the multiorgan involvement, sarcoidosis can present to clinicians in almost every specialty, but most often to chest physicians, opthalmologists, and dermatologists. The course and prognosis correlate with the mode of onset. An acute onset is usually indicative of a self-limited course of spontaneous resolution whereas an insidious onset may be followed by relentless, progressive pulmonary fibrosis. Current therapy uses both anti-inflammatory agents (e.g., steroids) and immunosuppressive drugs (e.g., methotrexate).