Sarcoidosis history and symptoms: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
No edit summary
 
(8 intermediate revisions by the same user not shown)
Line 4: Line 4:


==Overview==
==Overview==
[[Sarcoidosis]] is a multisystem [[granulomatous]] disorder of unknown etiology that can involve all organ systems to varying extent and degree.


==History and Symptoms==
==History and Symptoms==
===Pulmonary Sarcoidosis===
===[[Pulmonary Sarcoidosis]]===
* [[Sarcoidosis]] commonly involves patients between 20 and 60 years of age<ref>Judson MA, Boan AD, Lackland DT: The clinical course of sarcoidosis: presentation, diagnosis, and treatment in a large white and black cohort in the United States. Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG 2012, 29(2):119-127.</ref>. Lung is the most common organ involved by [[sarcoidosis]], but up to 30% of patients present with [[extrapulmonary sarcoidosis]]<ref>Ungprasert P, Carmona EM, Utz JP, Ryu JH, Crowson CS, Matteson EL: Epidemiology of Sarcoidosis 1946-2013: A Population-Based Study. Mayo Clinic proceedings 2016, 91(2):183-188.</ref><ref>Baughman RP, Teirstein AS, Judson MA, Rossman MD, Yeager H, Jr., Bresnitz EA, DePalo L, Hunninghake G, Iannuzzi MC, Johns CJ et al: Clinical characteristics of patients in a case control study of sarcoidosis. American journal of respiratory and critical care medicine 2001, 164(10 Pt 1):1885-1889.</ref>. [[Pulmonary sarcoidosis]] commonly presents with [[cough]], [[dyspnea]], [[chest pain]], and infrequently [[fatigue]], [[malaise]], [[fever]], and [[weight loss]]<ref>Sharma OP: Fatigue and sarcoidosis. The European respiratory journal 1999, 13(4):713-714.</ref>.
* [[Sarcoidosis]] commonly involves patients between 20 and 60 years of age<ref>Judson MA, Boan AD, Lackland DT: The clinical course of sarcoidosis: presentation, diagnosis, and treatment in a large white and black cohort in the United States. Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG 2012, 29(2):119-127.</ref>. Lung is the most common organ involved by [[sarcoidosis]], but up to 30% of patients present with [[extrapulmonary sarcoidosis]]<ref>Ungprasert P, Carmona EM, Utz JP, Ryu JH, Crowson CS, Matteson EL: Epidemiology of Sarcoidosis 1946-2013: A Population-Based Study. Mayo Clinic proceedings 2016, 91(2):183-188.</ref><ref>Baughman RP, Teirstein AS, Judson MA, Rossman MD, Yeager H, Jr., Bresnitz EA, DePalo L, Hunninghake G, Iannuzzi MC, Johns CJ et al: Clinical characteristics of patients in a case control study of sarcoidosis. American journal of respiratory and critical care medicine 2001, 164(10 Pt 1):1885-1889.</ref>. [[Pulmonary sarcoidosis]] commonly presents with [[cough]], [[dyspnea]], [[chest pain]], and infrequently [[fatigue]], [[malaise]], [[fever]], and [[weight loss]]<ref>Sharma OP: Fatigue and sarcoidosis. The European respiratory journal 1999, 13(4):713-714.</ref>.
* Young children can present with [[skin rash]], [[arthritis]], [[uveitis]], and [[erythema nodosum]], without a predominant lung involvement<ref>Pattishall EN, Kendig EL, Jr.: Sarcoidosis in children. Pediatric pulmonology 1996, 22(3):195-203.</ref><ref>Milman N, Hoffmann AL: Childhood sarcoidosis: long-term follow-up. The European respiratory journal 2008, 31(3):592-598.</ref>
* Young children can present with [[skin rash]], [[arthritis]], [[uveitis]], and [[erythema nodosum]], without a predominant lung involvement<ref>Pattishall EN, Kendig EL, Jr.: Sarcoidosis in children. Pediatric pulmonology 1996, 22(3):195-203.</ref><ref>Milman N, Hoffmann AL: Childhood sarcoidosis: long-term follow-up. The European respiratory journal 2008, 31(3):592-598.</ref>


===Cutaneous Sarcoidosis===
===[[Cutaneous Sarcoidosis]]===
in 25% of the patients diagnosed with [[sarcoidosis]], cutaneous involvement is seen<ref>Roberts SD, Mirowski GW, Wilkes D, Kwo PY, Knox KS: Sarcoidosis. Part II: extrapulmonary and systemic manifestations. Journal of the American Academy of Dermatology 2004, 51(4):628-630.</ref>. The most common patterns of involvement is: papular, nodular, [[plaque-like]], [[lupus pernio]], [[erythema nodosum]], subcutaneous sarcoidosis. See cutaneous manifestations of [[sarcoidosis]] in physical exam for more detail.
In 25% of the patients diagnosed with [[sarcoidosis]], cutaneous involvement is seen<ref>Roberts SD, Mirowski GW, Wilkes D, Kwo PY, Knox KS: Sarcoidosis. Part II: extrapulmonary and systemic manifestations. Journal of the American Academy of Dermatology 2004, 51(4):628-630.</ref>. The most common patterns of involvement is: papular, nodular, [[plaque-like]], [[lupus pernio]], [[erythema nodosum]], subcutaneous sarcoidosis. See cutaneous manifestations of [[sarcoidosis]] in physical exam for more detail.


===Ocular Sarcoidosis===
===[[Ocular Sarcoidosis]]===


in 25% of the patients diagnosed with [[sarcoidosis]], ocular involvement is seen<ref>Jamilloux Y, Kodjikian L, Broussolle C, Seve P: Sarcoidosis and uveitis. Autoimmunity reviews 2014, 13(8):840-849.</ref>. [[Sarcoidosis]] involves the [[orbit]], [[anterior segment]], [[posterior segment]], [[conjunctiva]], [[lacrimal glands]], and [[extraocular muscles]]. the usual symptoms include [[dry eye]], [[blurred vision]], [[photophobia]], [[red eye]], and pain<ref name="uv">Evans M, Sharma O, LaBree L, Smith RE, Rao NA: Differences in clinical findings between Caucasians and African Americans with biopsy-proven sarcoidosis. Ophthalmology 2007, 114(2):325-333</ref><ref>Birnbaum AD, French DD, Mirsaeidi M, Wehrli S: Sarcoidosis in the national veteran population: association of ocular inflammation and mortality. Ophthalmology 2015, 122(5):934-938.</ref> .
In 25% of the patients diagnosed with [[sarcoidosis]], ocular involvement is seen<ref>Jamilloux Y, Kodjikian L, Broussolle C, Seve P: Sarcoidosis and uveitis. Autoimmunity reviews 2014, 13(8):840-849.</ref>. [[Sarcoidosis]] involves the [[orbit]], [[anterior segment]], [[posterior segment]], [[conjunctiva]], [[lacrimal glands]], and [[extraocular muscles]]. the usual symptoms include [[dry eye]], [[blurred vision]], [[photophobia]], [[red eye]], and pain<ref name="uv">Evans M, Sharma O, LaBree L, Smith RE, Rao NA: Differences in clinical findings between Caucasians and African Americans with biopsy-proven sarcoidosis. Ophthalmology 2007, 114(2):325-333</ref><ref>Birnbaum AD, French DD, Mirsaeidi M, Wehrli S: Sarcoidosis in the national veteran population: association of ocular inflammation and mortality. Ophthalmology 2015, 122(5):934-938.</ref> .
*'''Intraocular sarcoidosis''': these include anterior, intermediate, and posterior [[uveitis]]. Typical symptoms of anterior [[uveitis]] are pain and redness perticularly at the junction between [[cornea]] and [[sclera]] ([[limbus]]), while posterior and/or intermediate [[uveitis]] causes no symptom or [[floaters]]<ref name="uv">Evans M, Sharma O, LaBree L, Smith RE, Rao NA: Differences in clinical findings between Caucasians and African Americans with biopsy-proven sarcoidosis. Ophthalmology 2007, 114(2):325-333</ref>.
*'''Intraocular sarcoidosis''': these include anterior, intermediate, and posterior [[uveitis]]. Typical symptoms of anterior [[uveitis]] are pain and redness perticularly at the junction between [[cornea]] and [[sclera]] ([[limbus]]), while posterior and/or intermediate [[uveitis]] causes no symptom or [[floaters]]<ref name="uv">Evans M, Sharma O, LaBree L, Smith RE, Rao NA: Differences in clinical findings between Caucasians and African Americans with biopsy-proven sarcoidosis. Ophthalmology 2007, 114(2):325-333</ref>.
*'''extraocular orbital sarcoidosis''': involvement of [[lacrimal glands]], [[conjunctiva]], [[extraocular muscles]], [[optic nerve]] and palpable mass<ref>Mavrikakis I, Rootman J: Diverse clinical presentations of orbital sarcoid. American journal of ophthalmology 2007, 144(5):769-775.</ref>.
*'''extraocular orbital sarcoidosis''': involvement of [[lacrimal glands]], [[conjunctiva]], [[extraocular muscles]], [[optic nerve]] and palpable mass<ref>Mavrikakis I, Rootman J: Diverse clinical presentations of orbital sarcoid. American journal of ophthalmology 2007, 144(5):769-775.</ref>.
Line 23: Line 24:
[[Sarcoidosis]] can involve the [[larynx]], [[pharynx]], [[nares]], and sinuses. The symptoms can include [[cough]], [[dysphagia]], [[hoarsness]], [[nasal obstruction]], [[nasal crusting]], [[anosmia]], [[epistaxis]], and [[nasal polyposis]]<ref>Baughman RP, Lower EE, Tami T: Upper airway. 4: Sarcoidosis of the upper respiratory tract (SURT). Thorax 2010, 65(2):181-186.</ref><ref>Reed J, deShazo RD, Houle TT, Stringer S, Wright L, Moak JS, 3rd: Clinical features of sarcoid rhinosinusitis. The American journal of medicine 2010, 123(9):856-862.</ref>.
[[Sarcoidosis]] can involve the [[larynx]], [[pharynx]], [[nares]], and sinuses. The symptoms can include [[cough]], [[dysphagia]], [[hoarsness]], [[nasal obstruction]], [[nasal crusting]], [[anosmia]], [[epistaxis]], and [[nasal polyposis]]<ref>Baughman RP, Lower EE, Tami T: Upper airway. 4: Sarcoidosis of the upper respiratory tract (SURT). Thorax 2010, 65(2):181-186.</ref><ref>Reed J, deShazo RD, Houle TT, Stringer S, Wright L, Moak JS, 3rd: Clinical features of sarcoid rhinosinusitis. The American journal of medicine 2010, 123(9):856-862.</ref>.


===Cardiac Sarcoidosis===
===[[Cardiac Sarcoidosis]]===
 
The exact rate of myocardial involvement in [[sarcoidosis]] is not clear, but it ranges from 5% in patients with systemic [[sarcoidosis]] to 25 and even 70% in autopsy studies. Patients may complain of [[palpitation]]s, [[syncope]], [[lightheadedness]], and [[chest pain]]. [[sudden cardiac death]] ([[SCD]]) can occur<ref>Kron J, Ellenbogen KA: Cardiac sarcoidosis: contemporary review. Journal of cardiovascular electrophysiology 2015, 26(1):104-109.</ref><ref>Darlington P, Gabrielsen A, Sorensson P, Cederlund K, Eklund A, Grunewald J: Cardiac involvement in Caucasian patients with pulmonary sarcoidosis. Respiratory research 2014, 15:15</ref>.
 
===Neurosarcoidosis===
Sarcoidosis can involve both Central and Peripheral nervous system in 5% of patients. The common symptoms include:
* Peripheral [[facial nerve palsy]] in 25 to 50% of patients with neurosarcoidosis<ref>Stern BJ, Krumholz A, Johns C, Scott P, Nissim J: Sarcoidosis and its neurological manifestations. Archives of neurology 1985, 42(9):909-917.</ref><ref name="sl">Joseph FG, Scolding NJ: Neurosarcoidosis: a study of 30 new cases. Journal of neurology, neurosurgery, and psychiatry 2009, 80(3):297-304.</ref>
* [[Polyuria]] and impairment in sleep, [[thirst]], [[body temprature]] and [[libido]] due to hypothalamic inflammation<ref name="sl">Joseph FG, Scolding NJ: Neurosarcoidosis: a study of 30 new cases. Journal of neurology, neurosurgery, and psychiatry 2009, 80(3):297-304.</ref><ref>Bihan H, Christozova V, Dumas JL, Jomaa R, Valeyre D, Tazi A, Reach G, Krivitzky A, Cohen R: Sarcoidosis: clinical, hormonal, and magnetic resonance imaging (MRI) manifestations of hypothalamic-pituitary disease in 9 patients and review of the literature. Medicine 2007, 86(5):259-268.</ref>
* Seizures<ref>Pawate S, Moses H, Sriram S: Presentations and outcomes of neurosarcoidosis: a study of 54 cases. QJM : monthly journal of the Association of Physicians 2009, 102(7):449-460.</ref>
 
 
 
 
===Reticuloendothelial System===
Involvement of the [[lymph node]]s, [[liver]], and [[spleen]] is common in [[sarcoidosis]]. The patients may present with neck or axillary mass. liver and spleen involvement is usually asymptomatic<ref>Warshauer DM, Lee JK: Imaging manifestations of abdominal sarcoidosis. AJR American journal of roentgenology 2004, 182(1):15-28.</ref>.
 
===Musculocutaneous===
There are 3 common patterns of musculocutaneous involvement in sarcoidosis: 1. [[Acute sarcoid arthritis]] or acute polyarthritis 2. Chronic arthritis 3. [[Myopathy]]([[diffuse granulomatous myositis]])<ref>Kellner H, Spathling S, Herzer P: Ultrasound findings in Lofgren's syndrome: is ankle swelling caused by arthritis, tenosynovitis or periarthritis? The Journal of rheumatology 1992, 19(1):38-41.</ref>.
 
===[[Lofgren Syndrome]]===
The presence of [[erythema nodosum]], [[hilar lymphadenopathy]], [[migratory polyarthralgia]], and [[fever]] has a 95% diagnostic [[specifity]] for [[sarcoidosis]], allowing  a diagnosis to be made without biopsy, and is associated with a good prognosis<ref>O'Regan A, Berman JS: Sarcoidosis. Annals of internal medicine 2012, 156(9):ITC5-1, ITC5-2, ITC5-3, ITC5-4, ITC5-5, ITC5-6, ITC5-7, ITC5-8, ITC5-9, ITC5-10, ITC15-11, ITC15-12, ITC15-13, ITC15-14, ITC15-15; quiz ITC15-16.</ref>.
 
===Exocrine Glands===
In 5% of the patients diagnosed with [[sarcoidosis]], painless swelling of [[salivary glands]] and [[parotid]] gland occurs. [[Sicca syndrome]] and [[xerostomia]] may also be seen<ref>James DG, Sharma OP: Parotid gland sarcoidosis. Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG 2000, 17(1):27-32.</ref>.
 
===Renal & Electrolyte===
* Symptoms caused by [[hypercalcemia]] (presenting feature in 10 to 20 percent of patients)
* Renal colic caused by [[nephrolithiasis]] (presenting feature 4 percent of patients)
* Symptoms caused by uremia due to [[interstitial nephritis]]
* Symptoms caused by [[proteinuria]] (various types of glumerulonephritis may be seen)<ref>Rizzato G, Colombo P: Nephrolithiasis as a presenting feature of chronic sarcoidosis: a prospective study. Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG 1996, 13(2):167-172.</ref><ref>presentation of sarcoidosis: a frequent occurrence but a challenge to an early diagnosis. A 3-year-long prospective observational study. Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG 2004, 21(2):119-126</ref>.
 
 
 


The exact rate of myocardial involvement in [[sarcoidosis]] is not clear, but it ranges from 5% in patients with systemic [[sarcoidosis]] to 25 and even 70% in autopsy studies. patients may complain of [[palpitation]]s, [[syncope]], [[lightheadedness]], and [[chest pain]]. [[sudden cardiac death]] ([[SCD]]) can occur<ref>Kron J, Ellenbogen KA: Cardiac sarcoidosis: contemporary review. Journal of cardiovascular electrophysiology 2015, 26(1):104-109.</ref><ref>Darlington P, Gabrielsen A, Sorensson P, Cederlund K, Eklund A, Grunewald J: Cardiac involvement in Caucasian patients with pulmonary sarcoidosis. Respiratory research 2014, 15:15</ref>.


==References==
==References==

Latest revision as of 22:12, 14 May 2018

Sarcoidosis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Sarcoidosis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Sarcoidosis history and symptoms On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Sarcoidosis history and symptoms

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Sarcoidosis history and symptoms

CDC on Sarcoidosis history and symptoms

Sarcoidosis history and symptoms in the news

Blogs on Sarcoidosis history and symptoms

Directions to Hospitals Treating Sarcoidosis

Risk calculators and risk factors for Sarcoidosis history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Roshan Dinparasti Saleh M.D.

Overview

Sarcoidosis is a multisystem granulomatous disorder of unknown etiology that can involve all organ systems to varying extent and degree.

History and Symptoms

Pulmonary Sarcoidosis

Cutaneous Sarcoidosis

In 25% of the patients diagnosed with sarcoidosis, cutaneous involvement is seen[7]. The most common patterns of involvement is: papular, nodular, plaque-like, lupus pernio, erythema nodosum, subcutaneous sarcoidosis. See cutaneous manifestations of sarcoidosis in physical exam for more detail.

Ocular Sarcoidosis

In 25% of the patients diagnosed with sarcoidosis, ocular involvement is seen[8]. Sarcoidosis involves the orbit, anterior segment, posterior segment, conjunctiva, lacrimal glands, and extraocular muscles. the usual symptoms include dry eye, blurred vision, photophobia, red eye, and pain[9][10] .

Upper Respiratory Tract Disease

Sarcoidosis can involve the larynx, pharynx, nares, and sinuses. The symptoms can include cough, dysphagia, hoarsness, nasal obstruction, nasal crusting, anosmia, epistaxis, and nasal polyposis[12][13].

Cardiac Sarcoidosis

The exact rate of myocardial involvement in sarcoidosis is not clear, but it ranges from 5% in patients with systemic sarcoidosis to 25 and even 70% in autopsy studies. Patients may complain of palpitations, syncope, lightheadedness, and chest pain. sudden cardiac death (SCD) can occur[14][15].

Neurosarcoidosis

Sarcoidosis can involve both Central and Peripheral nervous system in 5% of patients. The common symptoms include:



Reticuloendothelial System

Involvement of the lymph nodes, liver, and spleen is common in sarcoidosis. The patients may present with neck or axillary mass. liver and spleen involvement is usually asymptomatic[20].

Musculocutaneous

There are 3 common patterns of musculocutaneous involvement in sarcoidosis: 1. Acute sarcoid arthritis or acute polyarthritis 2. Chronic arthritis 3. Myopathy(diffuse granulomatous myositis)[21].

Lofgren Syndrome

The presence of erythema nodosum, hilar lymphadenopathy, migratory polyarthralgia, and fever has a 95% diagnostic specifity for sarcoidosis, allowing a diagnosis to be made without biopsy, and is associated with a good prognosis[22].

Exocrine Glands

In 5% of the patients diagnosed with sarcoidosis, painless swelling of salivary glands and parotid gland occurs. Sicca syndrome and xerostomia may also be seen[23].

Renal & Electrolyte



References

  1. ↑ Judson MA, Boan AD, Lackland DT: The clinical course of sarcoidosis: presentation, diagnosis, and treatment in a large white and black cohort in the United States. Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG 2012, 29(2):119-127.
  2. ↑ Ungprasert P, Carmona EM, Utz JP, Ryu JH, Crowson CS, Matteson EL: Epidemiology of Sarcoidosis 1946-2013: A Population-Based Study. Mayo Clinic proceedings 2016, 91(2):183-188.
  3. ↑ Baughman RP, Teirstein AS, Judson MA, Rossman MD, Yeager H, Jr., Bresnitz EA, DePalo L, Hunninghake G, Iannuzzi MC, Johns CJ et al: Clinical characteristics of patients in a case control study of sarcoidosis. American journal of respiratory and critical care medicine 2001, 164(10 Pt 1):1885-1889.
  4. ↑ Sharma OP: Fatigue and sarcoidosis. The European respiratory journal 1999, 13(4):713-714.
  5. ↑ Pattishall EN, Kendig EL, Jr.: Sarcoidosis in children. Pediatric pulmonology 1996, 22(3):195-203.
  6. ↑ Milman N, Hoffmann AL: Childhood sarcoidosis: long-term follow-up. The European respiratory journal 2008, 31(3):592-598.
  7. ↑ Roberts SD, Mirowski GW, Wilkes D, Kwo PY, Knox KS: Sarcoidosis. Part II: extrapulmonary and systemic manifestations. Journal of the American Academy of Dermatology 2004, 51(4):628-630.
  8. ↑ Jamilloux Y, Kodjikian L, Broussolle C, Seve P: Sarcoidosis and uveitis. Autoimmunity reviews 2014, 13(8):840-849.
  9. ↑ 9.0 9.1 Evans M, Sharma O, LaBree L, Smith RE, Rao NA: Differences in clinical findings between Caucasians and African Americans with biopsy-proven sarcoidosis. Ophthalmology 2007, 114(2):325-333
  10. ↑ Birnbaum AD, French DD, Mirsaeidi M, Wehrli S: Sarcoidosis in the national veteran population: association of ocular inflammation and mortality. Ophthalmology 2015, 122(5):934-938.
  11. ↑ Mavrikakis I, Rootman J: Diverse clinical presentations of orbital sarcoid. American journal of ophthalmology 2007, 144(5):769-775.
  12. ↑ Baughman RP, Lower EE, Tami T: Upper airway. 4: Sarcoidosis of the upper respiratory tract (SURT). Thorax 2010, 65(2):181-186.
  13. ↑ Reed J, deShazo RD, Houle TT, Stringer S, Wright L, Moak JS, 3rd: Clinical features of sarcoid rhinosinusitis. The American journal of medicine 2010, 123(9):856-862.
  14. ↑ Kron J, Ellenbogen KA: Cardiac sarcoidosis: contemporary review. Journal of cardiovascular electrophysiology 2015, 26(1):104-109.
  15. ↑ Darlington P, Gabrielsen A, Sorensson P, Cederlund K, Eklund A, Grunewald J: Cardiac involvement in Caucasian patients with pulmonary sarcoidosis. Respiratory research 2014, 15:15
  16. ↑ Stern BJ, Krumholz A, Johns C, Scott P, Nissim J: Sarcoidosis and its neurological manifestations. Archives of neurology 1985, 42(9):909-917.
  17. ↑ 17.0 17.1 Joseph FG, Scolding NJ: Neurosarcoidosis: a study of 30 new cases. Journal of neurology, neurosurgery, and psychiatry 2009, 80(3):297-304.
  18. ↑ Bihan H, Christozova V, Dumas JL, Jomaa R, Valeyre D, Tazi A, Reach G, Krivitzky A, Cohen R: Sarcoidosis: clinical, hormonal, and magnetic resonance imaging (MRI) manifestations of hypothalamic-pituitary disease in 9 patients and review of the literature. Medicine 2007, 86(5):259-268.
  19. ↑ Pawate S, Moses H, Sriram S: Presentations and outcomes of neurosarcoidosis: a study of 54 cases. QJM : monthly journal of the Association of Physicians 2009, 102(7):449-460.
  20. ↑ Warshauer DM, Lee JK: Imaging manifestations of abdominal sarcoidosis. AJR American journal of roentgenology 2004, 182(1):15-28.
  21. ↑ Kellner H, Spathling S, Herzer P: Ultrasound findings in Lofgren's syndrome: is ankle swelling caused by arthritis, tenosynovitis or periarthritis? The Journal of rheumatology 1992, 19(1):38-41.
  22. ↑ O'Regan A, Berman JS: Sarcoidosis. Annals of internal medicine 2012, 156(9):ITC5-1, ITC5-2, ITC5-3, ITC5-4, ITC5-5, ITC5-6, ITC5-7, ITC5-8, ITC5-9, ITC5-10, ITC15-11, ITC15-12, ITC15-13, ITC15-14, ITC15-15; quiz ITC15-16.
  23. ↑ James DG, Sharma OP: Parotid gland sarcoidosis. Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG 2000, 17(1):27-32.
  24. ↑ Rizzato G, Colombo P: Nephrolithiasis as a presenting feature of chronic sarcoidosis: a prospective study. Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG 1996, 13(2):167-172.
  25. ↑ presentation of sarcoidosis: a frequent occurrence but a challenge to an early diagnosis. A 3-year-long prospective observational study. Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG 2004, 21(2):119-126

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Sarcoidosis_history_and_symptoms&oldid=1470780"