[Sarcoidosis]

Sarcoidosis is a chronic generalized benign granulomatous disorder of perhaps an autoimmune character which can afflict many organs. The insidious form prevails, a (sub)acute onset covers about one third of cases. In most patients the lungs are involved; tissue damage by granulomas and inflammatory cells causes a reduction of respiratory capacity, with dyspnoea as a result. Other often-affected organs are larger joints, skin and eyes. The diagnosis is based on the symptoms, thoracic x-ray and histology. In most cases prednisone is the drug of first choice. It is tantalizing to have to decide whether to treat or not. The decision is based on the severity of the process in vital organs.