Sarcoidosis

Abstract Sarcoidosis is a disease of unknown cause that is characterized by the presence of non-caseating granulomas in at least two organs. It can present in a wide variety of ways. Differential diagnosis is most commonly from tuberculosis or lymphoma. Most patients with sarcoidosis will experience disease resolution within 2–5 years; about 25% will develop residual fibrosis in the lungs or elsewhere; in a few the disease will become chronic and persist for more than 5 years. Most series from referral centres report 5% disease-related mortality, usually from respiratory failure. There is no single treatment for all patients with sarcoidosis. First-line treatment is usually with corticosteroids, although it is not universally accepted that steroids change the course of the disease. If the dose of steroid cannot be reduced to an acceptable level, or if the patient is not responding, then other agents (e.g. chloroquine/hydroxychloroquine, methotrexate, leflunomide, infliximab) are added.