• 10-20/100000
• common in African Americans 4:1

3. Hstopathology

• noncaseating granuloma of lung

caused by focal, chronic inflammation formed by accumulation of epithelial cells, monocytes, lymphocytes, macrophages, fibroblasts

4. Clinical manifestations

• usually presents: age 10-40
• usually discovered incidentally by abnormal cxr
• can see cough, dyspnea, chest pain and less commonly malaise, fever, weakness

5. Radiographic manifestation -"must know"

• Lung involvement in 90% of patients with sarcoid
• Classification of pulmonary involvement in sarcoid based upon XR stage of disease

6. Extrapulmonary sarcoidosis

• Skin- maculopapular eruption – lips, eyelids, forehead
• Plaque like lesions – lupus pernio
• Ophthalmologic disease – iridocyclitis, keratoconjunctivitis, secondary glaucoma, cataracts, blindness

Heerfordt’s syndrome – iridocyclitis, parotid gland enlargement, facial palsy and fever

• Reticuloendothelial system – peripheral lymphadenopathy, hepatomegaly, splenomegaly
• Musculoskeletal – polyarthritis
• Electrolyte abnormalities – hypercalcemia
• Cardiovascular disease – granulomatous involvement of conduction systems

7. Lab abnormalities

Leukopenia (5-10%), eosinophilia (25%), ESR increased,Hypercalcemia

PFT – restrictive pattern and reduced DLCO, but can be normal

85 % of patients never need to be treated

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