Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- tosse
- dispneia
- fadiga crônica
- artralgia
- sibilância
- roncos
- linfadenopatia
- fotofobia
- olho dolorido e vermelho
- visão turva
- eritema nodoso
- lúpus pérnio
- nódulos conjuntivais
- paralisia facial
Other diagnostic factors
- ausência de história de exposição a berílio
- dor na parede torácica
- hemoptise
- perda de peso
- febre baixa
- arritmias
- bloqueio atrioventricular
- hepatomegalia
- cefaleia
- convulsões
- sintomas e sinais de lesão hipofisária
Risk factors
- idade 20-50 anos
- história familiar de sarcoidose
- origem escandinava
- sexo feminino
- não fumantes
- ascendência negra
- ascendência negra: uveíte
- origem porto-riquenha: lupus pernio
- Origem europeia: eritema nodoso
Diagnostic tests
1st tests to order
- radiografia torácica
- Hemograma completo
- ureia sérica
- creatinina sérica
- enzimas hepáticas
- cálcio sérico
- testes de função pulmonar
- eletrocardiograma (ECG)
- exame oftalmológico
- teste de liberação de gamainterferona
Tests to consider
- enzima conversora da angiotensina (ECA) sérica
- TC do tórax
- aspiração por agulha transbrônquica guiada por ultrassonografia endobrônquica
- lavagem broncoalveolar (LBA)
- biópsia de pele
- cálcio urinário de 24 horas
- cintigrafia com gálio-67
- vitamina D
- RNM
- tomografia por emissão de pósitrons (PET) com (18)F-fluordesoxiglucose (FDG)
Emerging tests
- PET com 3'-desoxi-3'-[18F]-fluorotimidina (FLT)
- PET-CT com 4'-[metil-11C]-tiotimidina
Treatment algorithm
em insuficiência respiratória aguda e incapaz de tolerar ingestão oral
em insuficiência respiratória aguda mas capaz de tolerar ingestão oral
doença pulmonar
doença cutânea
doença ocular
doença cardiovascular
envolvimento do sistema nervoso central ou do sistema nervoso periférico
doença renal
Contributors
Authors
Muthiah P. Muthiah, MD, FCCP
Acting Chief of Pulmonary, Critical Care & Sleep Medicine
VA Medical Center, Memphis
Professor & Vice Chair of Medicine
University of Tennessee Health Science Center
Memphis
TN
Disclosures
MPM declares that he has no competing interests.
Amr El Gamal, MD, FCCP
Pulmonary and Critical Care
Medical Service
VA Medical Center
Martinsburg
Assistant Professor of Medicine
West Virginia University
Morgantown
WV
Disclosures
AEG declares that he has served as a reviewer for the American Physician Institute.
Peer reviewers
George Swingler, MD
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.
Kyle Hogarth, MD, FCCP
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.
Marc Judson, MD
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.
Nadera Sweiss, MD
Assistant Professor of Medicine
Section of Rheumatology
Department of Medicine
University of Chicago
Chicago
IL
Disclosures
NS declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
American Thoracic Society. 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. 1999 Aug;160(2):736-55.Full text Abstract
Thillai M, Atkins CP, Crawshaw A, et al. BTS clinical statement on pulmonary sarcoidosis. Thorax. 2021 Jan;76(1):4-20.Full text Abstract
Crouser ED, Maier LA, Wilson KC, et al. Diagnosis and detection of sarcoidosis. An official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med. 2020 Apr 15;201(8):e26-51.Full text Abstract
Cheng RK, Kittleson MM, Beavers CJ, et al. Diagnosis and management of cardiac sarcoidosis: a scientific statement from the American Heart Association. Circulation. 2024 May 21;149(21):e1197-216.Full text Abstract
Baughman RP, Valeyre D, Korsten P, et al. ERS clinical practice guidelines on treatment of sarcoidosis. Eur Respir J. 2021 Dec;58(6):2004079.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Tuberculose
- Histoplasmose
- Câncer pulmonar de células não pequenas
More DifferentialsGuidelines
- Diagnosis and management of cardiac sarcoidosis: a scientific statement from the American Heart Association
- ERS clinical practice guidelines on treatment of sarcoidosis
More GuidelinesPatient information
Sarcoidose
More Patient information
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