Sarcoidosis: a review

Sarcoidosis is a systemic inflammatory disorder characterized by non-caseating granulomas found in the lung, lymphatic systems, and potentially in a host of other tissues and organs. Despite intriguing hints of infectious or environmental etiology, causation remains a mystery. The diagnosis, therefore, requires demonstration of granulomatous inflammation in more than one organ and exclusion of any of the known causes of granulomatous disease or local sarcoid reaction. Clinicians and underwriters alike frequently forget the latter requirement. For this reason, the other causes of granulomatous inflammation will be included in this treatise. Although the vast majority of applicants with sarcoidosis exhibit limited or remitting disease, the remaining applicants represent increased risk of both morbidity and mortality. This paper reviews the relevant clinical, radiographic, and laboratory findings that may help identify those applicants with increased or prohibitive risk for life or disability insurance.