[Severe extrapulmonary forms of sarcoidosis]

Severe extrapulmonary sarcoidosis mainly consists of cardiac and neuromuscular involvement, both of which compromise the functional prognosis and survival. Their rare occurrence is a major factor in delayed diagnosis and treatment when they are the presenting signs of the disease, and especially when not associated to the "classic" signs of sarcoidosis. The lack of clinical and paraclinical specificity hinders diagnosis, and in the absence of histological evidence, all clinical and paraclinical factors compatible with sarcoidosis must be taken into account. Since these localisations are often asymptomatic or poorly symptomatic, they should be routinely sought by careful clinical examination and electrocardiogram. The presence of such signs modifies the therapeutic approach and requires treatment with corticosteroids.