Sarcoidosis Manifestations Overview

Pulmonary Manifestations of Sarcoidosis

• Bilateral hilar adenopathy is a common finding, present in 50% of cases at initial diagnosis.
• Interstitial infiltrates are also observed.

Cutaneous Manifestations of Sarcoidosis

• Skin lesions can be papular, nodular, or plaque-like.
• Erythema nodosum is a characteristic cutaneous manifestation.

Ophthalmologic Manifestations of Sarcoidosis

• Anterior uveitis (including iridocyclitis and iritis)
• Posterior uveitis
• Keratoconjunctivitis sicca (dry eyes)

Reticuloendothelial Manifestations

• Peripheral lymphadenopathy
• Hepatomegaly (enlarged liver)
• Splenomegaly (enlarged spleen)

Musculoskeletal Manifestations

• Acute polyarthritis, especially affecting ankles
• Chronic arthritis

Cardiovascular Manifestations

• Atrioventricular block
• Dilated or restrictive cardiomyopathy

CNS/Endocrine Manifestations

• Facial nerve palsy
• Central diabetes insipidus
• Hypercalcemia

Löfgren Syndrome (a subset of sarcoidosis)

• Erythema nodosum
• Hilar adenopathy
• Migratory polyarthralgia
• Fever

General Characteristics of Sarcoidosis

• Chronic, multisystem disorder
• Noncaseating granulomatous inflammation is the underlying cause.
• Young adults are frequently affected.
• African Americans are 3-4 times more likely to have this condition than other population groups.
• More common in women than men.
• Often discovered incidentally during chest X-rays (50% of cases).
• Symptoms can include cough, dyspnea, fever, fatigue, and weight loss.

Diagnosis

• Definitive diagnosis requires consistent clinical and imaging findings, along with biopsy evidence of noncaseating granulomas.
• Bronchoscopy with transbronchial biopsy is a common method for obtaining tissue samples.
• For systemic involvement, accessible sites such as lymph nodes or cutaneous lesions can be biopsied.

Management of Patients with Incidental Findings

• Patients with incidental bilateral hilar adenopathy are often monitored without biopsy unless symptoms develop.