[Sarcoidosis: acute versus chronic--2 case reports]

Sarcoidosis manifests itself with different symptoms and can thereby follow an acute or chronic course. We will discuss one case each. Case 1 involves a 41-year-old patient with Loefgren's syndrome, showing the typical trias of erythema nodosum, bilateral hilar lymphadenopathy and acute polyarthritis. With systemic steroid treatment the symptoms disappeared rapidly. In case 2 we present a 39-year-old-man with chronic sarcoidosis for several years with no vital threat. His organ involvement includes chronic dacryocystitis. Systemic steroids relieved his symptoms and the dacryo-rhinostomy could perhaps have been prevented had the therapy been started earlier. Evaluating the diagnostic and therapeutic procedure can be difficult because there are no standard guidelines. A vital threat demands rapid diagnosis and effective therapy. The chronic illness requires a thorough evaluation of the appropriate therapy. We discuss the criteria for diagnosis, therapy and follow up.