A 47-year-old woman with sarcoidosis

Ms K, a 47-year-old woman, was found to have sarcoidosis after evaluation of an abnormal chest radiograph obtained during work-up of a recently diagnosed melanoma. She has symptoms of fatigue, achiness, and exertional dyspnea. She believes her symptoms are due to sarcoidosis and would like to get some symptomatic improvement, though she is reluctant to be treated with corticosteroids. She is interested in knowing about the likely course of her disease and the potential treatment options. The various presentations, protean manifestations, variable natural history, and attempts to understand the etiology of sarcoidosis are discussed. The principles underlying the decision of whether to institute treatment, the options for treatment, and the effectiveness of treatment are reviewed.