Hoarseness as an initial manifestation of sarcoidosis

A patient had hoarseness, the cause diagnosed as left recurrent laryngeal nerve palsy derived from enlarged sarcoid mediastinal lymph nodes. His symptoms were alleviated by steroid therapy, which was accompanied by the improvement of mediastinal lymph node swelling noted on chest x-ray film. Hoarseness may be listed as one of the symptoms of sarcoidosis.