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Sarcoidosis and the rheumatologist
Karina D Torralba1, Francisco P Quismorio
1Division of Rheumatology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA. ktorralb@usc.edu
Current Opinion in Rheumatology
|December 20, 2008
Summary
Rheumatologists face challenges diagnosing and treating sarcoidosis, a multisystem disease that mimics rheumatic conditions. Further research is needed on biomarkers and the safety of biologic therapies.
Area of Science:
- Rheumatology
- Immunology
- Internal Medicine
Background:
- Sarcoidosis is a complex multisystem granulomatous disease.
- Its clinical manifestations frequently overlap with or mimic various rheumatic diseases.
- This diagnostic challenge necessitates a thorough understanding for rheumatologists.
Purpose of the Study:
- To review the diagnostic and therapeutic challenges faced by rheumatologists in managing sarcoidosis.
- To highlight the similarities between sarcoidosis and other rheumatic conditions.
- To discuss current and emerging treatment strategies and their associated risks.
Main Methods:
- Literature review focusing on sarcoidosis diagnosis and treatment in rheumatology.
- Analysis of reported cases of sarcoidosis coexisting with or mimicking rheumatic diseases.
- Evaluation of current treatment modalities, including biologic therapies.
Main Results:
- Sarcoidosis presents heterogeneous features, often resembling systemic lupus erythematosus, rheumatoid arthritis, and ankylosing spondylitis.
- Musculoskeletal manifestations can be mistaken for infection or malignancy.
- Lack of reliable biomarkers for diagnosis and treatment monitoring complicates management.
- Tumor necrosis factor (TNF) inhibition is a potential treatment, but carries risks, including drug-induced sarcoidosis.
Conclusions:
- Significant knowledge gaps persist regarding sarcoidosis diagnosis and management.
- Further studies are required to validate serological and radiological biomarkers.
- The safety profile of biological response modifiers, particularly concerning the induction of sarcoidosis, warrants extensive investigation.
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