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# '''Renal disease'''
# '''Renal disease'''
## [[Nephrocalcinosis]]
## [[Nephrocalcinosis]]
## [[Interstitial nephritis]]<ref>Judson MA: The diagnosis of sarcoidosis. Clin Chest Med 29(3):415–427, 2008.</ref>
## [[Interstitial nephritis]]<ref name="judson">Judson MA: The diagnosis of sarcoidosis. Clin Chest Med 29(3):415–427, 2008.</ref>
 
===Data weakening the likelihood of [[sarcoidosis]]===
# '''Demographics'''
## Age< 18 years
 
# '''Medical history'''
## Exposure to [[tuberculosis]]
## Exposure to [[organic bioaerosol]]
## Exposure to [[beryllium]]
## [[Intravenous drug abuse]]
 
# '''Laboratory data'''
## Positive [[anti-neutrophil cytoplasm antibody]] ([[ANCA]])
 
#  '''Radiographic findings'''
## [[CXR]]:
### [[Pleural effusion]]
## [[HRCT]]:
### Subpleural [[honeycombing]]
 
# '''Ocular disease'''
## [[Episcleritis]]
 
# '''Renal disease'''
## [[Glumerulonephritis]] <ref name="judson">Judson MA: The diagnosis of sarcoidosis. Clin Chest Med 29(3):415–427, 2008.</ref>
 
   
   


Revision as of 15:33, 10 May 2018

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

Overview

Sarcoidosis has many differentials, which can be classified depending on the organ involved, pathologic findings and laboratory findings.

Differential Diagnosis

Sarcoidosis has been defined as a multisystem granulomatous disorder of unknown cause[1], but granulomatous inflammation alone is not sufficient for the diagnosis of sarcoidosis because alternative etiologies of granulomatous inflammation need to be excluded.

Causes of granulomatous reaction beside sarcoidosis

Data supporting the likelihood of sarcoidosis

  1. Demographics
    1. U.S. African American
    2. Northern European
  2. Medical history
    1. Non-smoker
    2. No symptoms(in patient with bilateral hilar adenopathy on CXR)
    3. Family history of sarcoidosis
    4. Symptoms involving more than two organs commonly involved by sarcoidosis
  3. Laboratory data
    1. Elevated ACE level (especially if > 2× ULN)
    2. Elevated calcium level
    3. Elevated alkaline phosphatase level
    4. Elevated soluble IL-2 receptor
    5. Leukopenia
  4. Radiographic findings
    1. CXR:
      1. bilateral hilar adenopathy especially if without symptoms)
      2. Upper lobe disease
    2. HRCT:
      1. Disease along bronchovascular bundle
      2. Subpleural reticulonodular infiltrates
      3. Mediastinal adenopathy
      4. Peribronchial thickening
      5. Traction bronchiectasis of upper lobe
  5. Skin lesions
    1. Lupus pernio
    2. Erythema nodosum
    3. Maculopapular lesions
  6. Ocular disease
    1. Uveitis
    2. Optic neuritis
  7. Neurological disease
    1. Seventh cranial nerve palsy
  8. Renal disease
    1. Nephrocalcinosis
    2. Interstitial nephritis[2]

Data weakening the likelihood of sarcoidosis

  1. Demographics
    1. Age< 18 years
  1. Medical history
    1. Exposure to tuberculosis
    2. Exposure to organic bioaerosol
    3. Exposure to beryllium
    4. Intravenous drug abuse
  1. Laboratory data
    1. Positive anti-neutrophil cytoplasm antibody (ANCA)
  1. Radiographic findings
    1. CXR:
      1. Pleural effusion
    2. HRCT:
      1. Subpleural honeycombing
  1. Ocular disease
    1. Episcleritis
  1. Renal disease
    1. Glumerulonephritis [2]






References

  1. ↑ 1.0 1.1 Statement on sarcoidosis: Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999. Am J Respir Crit Care Med 160:736–755, 1999.
  2. ↑ 2.0 2.1 Judson MA: The diagnosis of sarcoidosis. Clin Chest Med 29(3):415–427, 2008.
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