Summary
Definition
History and exam
Key diagnostic factors
- cough
- dyspnea
- chronic fatigue
- arthralgia
- wheezing
- rhonchi
- lymphadenopathy
- photophobia
- red painful eye
- blurred vision
- erythema nodosum
- lupus pernio
- conjunctival nodules
- facial palsy
Other diagnostic factors
- absent history of exposure to beryllium
- chest wall pain
- hemoptysis
- weight loss
- low-grade fever
- arrhythmias
- heart block
- hepatomegaly
- headache
- seizures
- symptoms and signs of pituitary lesion
Risk factors
- age 20-40 years
- FHx sarcoidosis
- female gender
- nonsmokers
- black ancestry (US): uveitis
- Scandinavian origin
- Puerto Rican origin: lupus pernio
- European origin: erythema nodosum
Diagnostic investigations
1st investigations to order
- CXR
- CBC
- serum BUN
- creatinine
- liver enzymes
- serum calcium
- PFTs
- ECG
- purified protein derivative of tuberculin (PPD)
Investigations to consider
- CT scan of chest
- flexible bronchoscopy with transbronchial lung biopsy
- bronchoalveolar lavage (BAL)
- skin biopsy
- 24-hour urine calcium
- serum ACE
- gallium-67 scan
- endobronchial ultrasound-transbronchial needle aspiration
Treatment algorithm
Contributors
Authors VIEW ALL
Associate Professor of Medicine
Division of Pulmonary and Critical Care and Sleep Medicine
Director
Pulmonary and Critical Care Medicine Fellowship Program
University of Tennessee
Memphis
TN
Disclosures
MPM declares that he has no competing interests.
Pulmonary and Critical Care
Medical Service
VA Medical Centre
Martinsburg
Assistant Professor of Medicine
West Virginia University
Morgantown
WV
Disclosures
AEG declares that he has no competing interests.
Peer reviewers VIEW ALL
Professor
School of Child and Adolescent Health
Red Cross Children's Hospital
University of Cape Town
Rondebosch
Cape Town
South Africa
Disclosures
GS declares that he has no competing interests.
Assistant Professor of Medicine
Department of Medicine
Section of Pulmonary and Critical Care
University of Chicago
Chicago
IL
Disclosures
KH declares that he has no competing interests.
Chief
Division of Pulmonary and Critical Care Medicine
AMC Pulmonary and Critical Care Medicine
Albany
NY
Disclosures
MJ declares that he has no competing interests.
Assistant Professor of Medicine
Section of Rheumatology
Department of Medicine
University of Chicago
Chicago
IL
Disclosures
NS declares that she has no competing interests.
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