[Diagnostic and treatment problems in sarcoidosis in the therapist's practice]

Altogether 231 sarcoidosis patients were observed. Chest x-ray showed stage I in 116 patients, stage II in 111 patients. Corticosteroid therapy was provided to stage II patients only, with signs of alveolitis activity, for which assessment lung scintigraphy with 67Ga, investigation of bronchoalveolar rinse and determination of the blood angiotensin converting enzyme should be performed. Various extrapulmonary manifestations like hepatosplenomegaly, skin rash, cardiac arrhythmia and conduction disorder, urinary syndrome, etc., were revealed in 28 patients. The authors discussed variants of a course of lesions of the internal organs in sarcoidosis, difficulties of their diagnosis, and indications for steroid therapy. They also recommend a further study of the extrathoracic manifestations of sarcoidosis which frequently determine prognosis of this disease (first of all, cardiac, renal and nervous system affections), serve indicators of its activity (erythema nodosum, uveitis, parotitis, etc.) and present considerable diagnostic difficulties.