Sarcoidosis

Abstract

Sarcoidosis is a multisystemic granulomatous disease of unknown etiology. The available evidence suggests that the disease results from an exposure of genetically susceptible hosts to specific environmental agents, which trigger a Th1 immunological response in the involved organs, leading to granuloma formation. Sarcoidosis usually presents with bilateral hilar lymphadenopathy, and pulmonary, cutaneous and ocular involvement, although any organ can be affected. The diagnosis is based on a compatible clinical and radiological picture, demonstration of noncaseating granulomas with negative cultures for mycobacteria and fungus, and exclusion of other granulomatous diseases. In general, an acute onset, particularly Löfgren’s syndrome, has a good prognosis, whereas an insidious presentation heralds a chronic disease. Corticosteroids should be administered when severe and progressive disease involves major organs such as lungs, eyes, heart and central nervous system. Several drugs may be useful as alternative therapies in cases refractory to corticosteroid treatment.