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Sarcoidosis.

Pilar Brito-Zerón1, Roberto Pérez-Álvarez2, Manuel Ramos-Casals3

  • 1Research and Innovation Group in Autoimmune Diseases, Sanitas Digital Hospital, Hospital-CIMA-Centre Mèdic Millenium Balmes Sanitas, Barcelona, España; Línea de Investigación en Sarcoidosis del GEAS, Sociedad Española de Medicina Interna (SEMI), Madrid, España.

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Summary

Sarcoidosis is a systemic autoimmune disease causing granulomas, primarily affecting lymph nodes, lungs, skin, and eyes. Diagnosis requires multidisciplinary data integration for variable treatment approaches.

Keywords:
Autoimmune diseaseCorticoidesCorticosteroidsEnfermedad autoinmuneGranulomasInfliximabSarcoidosis

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Area of Science:

  • Immunology
  • Systemic Autoimmune Diseases
  • Granulomatous Disorders

Background:

  • Sarcoidosis is a systemic autoimmune disease characterized by non-caseating granulomas.
  • It commonly affects lymph nodes, lungs, skin, and eyes, with higher prevalence in Northern Europe, the US, and India.
  • The disease predominantly affects women aged 30-50 and is linked to environmental and occupational exposures.

Purpose of the Study:

  • To provide a comprehensive overview of sarcoidosis, encompassing its epidemiology, etiology, clinical presentation, diagnostic challenges, and therapeutic strategies.
  • To highlight the complexity of sarcoidosis diagnosis, emphasizing the need for integrated multidisciplinary data.
  • To outline current treatment modalities, including first-line corticosteroids, second-line immunosuppressants, and anti-TNF agents for refractory cases.

Main Methods:

  • Review of existing literature on sarcoidosis epidemiology, pathogenesis, clinical features, diagnosis, and treatment.
  • Integration of clinical, analytical, radiological, and histopathological data for diagnostic assessment.
  • Multidisciplinary clinical unit collaboration for comprehensive patient management.

Main Results:

  • Sarcoidosis presents with diverse phenotypes, ranging from incidental findings to single-organ or systemic involvement.
  • Diagnosis is complex, necessitating a combination of clinical evaluation, laboratory tests, imaging, and histopathology.
  • Disease evolution and treatment indications are variable, with a stepwise therapeutic approach.

Conclusions:

  • Sarcoidosis diagnosis and management require a sophisticated, multidisciplinary approach due to its complex nature and varied presentation.
  • Effective treatment strategies are tailored to disease severity and patient response, utilizing corticosteroids, immunosuppressants, and biologics.
  • Further research into etiopathogenic factors and optimized therapeutic interventions remains crucial for improving patient outcomes.