Sarcoidosis differential diagnosis: Difference between revisions

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Revision as of 15:35, 10 May 2018

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

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

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.

Demographics
1. U.S. African American
2. Northern European
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
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
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
Skin lesions
1. Lupus pernio
2. Erythema nodosum
3. Maculopapular lesions
Ocular disease
1. Uveitis
2. Optic neuritis
Neurological disease
1. Seventh cranial nerve palsy
Renal disease
1. Nephrocalcinosis
2. Interstitial nephritis^[2]

Medical history
1. Exposure to tuberculosis
2. Exposure to organic bioaerosol
3. Exposure to beryllium
4. Intravenous drug abuse

Radiographic findings
1. CXR:
  1. Pleural effusion
2. HRCT:
  1. Subpleural honeycombing

↑ ^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.
↑ ^2.0 ^2.1 Judson MA: The diagnosis of sarcoidosis. Clin Chest Med 29(3):415–427, 2008.

Revision as of 15:34, 10 May 2018 view source Roshan (talk \| contribs) nocaptcha 217 edits No edit summary ← Older edit		Revision as of 15:35, 10 May 2018 view source Roshan (talk \| contribs) nocaptcha 217 edits No edit summary Newer edit →
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	# '''Renal disease'''		# '''Renal disease'''
	## [[~~Glumerulonephritis~~]] <ref name="judson">Judson MA: The diagnosis of sarcoidosis. Clin Chest Med 29(3):415–427, 2008.</ref>		## [[Glomerulonephritis]] <ref name="judson">Judson MA: The diagnosis of sarcoidosis. Clin Chest Med 29(3):415–427, 2008.</ref>