Enigmas in sarcoidosis

Sarcoidosis is a multisystem granulomatous disorder of unknown cause that presents most frequently in young adults with bilateral hilar adenopathy, pulmonary infiltrates, and skin or eye lesions. The multisystem clinical manifestations of this disease are a diagnostic challenge to all physicians. Although the clinical and pathologic characteristics of sarcoidosis are well described, the decision to treat and the optimal therapy are less well defined. This review focuses on the natural history, clinical manifestations, controversies in therapy, including steroid-sparing agents, and current concepts of how the disease's activity can be monitored.