Sarcoidosis: recognition and treatment guidelines

Area of Science:

• Immunology
• Pulmonology
• Systemic Inflammatory Diseases

Background:

• Sarcoidosis is a systemic disorder of unknown cause, marked by noncaseating granulomas.
• It commonly presents with bilateral hilar lymphadenopathies, pulmonary infiltration, and skin/eye lesions.
• Granulomas can affect multiple organs, including the liver and heart, even if clinical involvement is uncommon.

Purpose of the Study:

• To provide a comprehensive overview of sarcoidosis, including its etiology, diagnosis, clinical manifestations, and treatment strategies.
• To highlight the diagnostic criteria, emphasizing clinical, radiological, and histological evidence.
• To discuss the variable disease course and current therapeutic approaches, including their limitations.

Main Methods:

• Diagnosis relies on compatible clinical and radiological findings.
• Histological confirmation involves identifying noninfectious, noncaseating epithelioid cell granulomas.
• Literature review of established and emerging treatment modalities for sarcoidosis.

Main Results:

• Sarcoidosis diagnosis requires exclusion of other causes for granuloma formation.
• The disease course is variable, with frequent remissions but potential for chronic progression.
• Corticosteroids are a primary treatment, but long-term toxicity and relapses are issues.

Conclusions:

• Optimal sarcoidosis treatment remains under investigation.
• Corticosteroids are first-line for severe cases, with antimalarials or methotrexate for refractory disease.
• Immunosuppressants are used cautiously due to adverse effects and limited long-term data.