A clinical overview of sarcoidosis: Pathogenesis, symptoms, diagnosis and treatment

Abstract

Sarcoidosis is a granulomatous disorder characterized by non-caseating granulomas in multiple organs and an unknown cause. This chronic inflammatory disease is heterogeneous in terms of manifestations, duration, and severity. Although its aetiology is not well understood, there are indications of the genetic basis and the involvement of specific microorganisms and vitamin D in the development of this disease. Sarcoidosis can affect individuals of any age; however, it is more commonly observed in young adults and middle-aged subjects. The clinical course of the disease is unpredictable; nevertheless, in general, it can manifest as pulmonary, cardiac, cutaneous, ocular, skeletal-muscular, neurological, and renal involvement. Pulmonary involvement occurs in most patients and respiratory failure is the most common cause of death associated with sarcoidosis. Although numerous biomarkers have been evaluated in recent decades for patients with sarcoidosis, the diagnostic method is complex and no single diagnostic test can confirm the disease. Future research should focus on the combination of biomarkers and more refined imaging techniques, such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET). By utilizing these techniques and markers, it may be possible to design diagnostic and therapeutic approaches. Corticosteroids are considered the mainstay of treatment for most patients. Moreover, novel therapies, including the administration of rituximab and repository corticotropin injection (a combination of adrenocorticotropic hormone analogs and other pituitary peptides [RCI, Acthar® Gel]), have been reported to be effective in some cases.

Keywords

• diagnosis
• granulomatous
• imaging technique
• pathology
• sarcoidosis