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Sarcoidosis: Epidemiology and clinical insights. | LitMetric

Sarcoidosis: Epidemiology and clinical insights.

J Intern Med

Department of Medicine Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden.

Published: June 2023

AI Article Synopsis

  • Sarcoidosis is an inflammatory disease marked by noncaseating granulomas, primarily affecting the lungs and lymph nodes, influenced by genetic and environmental factors with varying incidence across different regions and races.
  • Diagnosis can be tricky due to its diverse presentations; key indicators include radiologic signs and confirmed histological findings, though no definitive biomarkers exist.
  • Treatment mainly involves corticosteroids for symptomatic relief, but long-term outcomes can vary greatly, highlighting the need for future research to personalize care and improve understanding of the disease.

Article Abstract

Sarcoidosis is characterized by noncaseating granulomas which form in almost any part of the body, primarily in the lungs and/or thoracic lymph nodes. Environmental exposures in genetically susceptible individuals are believed to cause sarcoidosis. There is variation in incidence and prevalence by region and race. Males and females are almost equally affected, although disease peaks at a later age in females than in males. The heterogeneity of presentation and disease course can make diagnosis and treatment challenging. Diagnosis is suggestive in a patient if one or more of the following is present: radiologic signs of sarcoidosis, evidence of systemic involvement, histologically confirmed noncaseating granulomas, sarcoidosis signs in bronchoalveolar lavage fluid (BALF), and low probability or exclusion of other causes of granulomatous inflammation. No sensitive or specific biomarkers for diagnosis and prognosis exist, but there are several that can be used to support clinical decisions, such as serum angiotensin-converting enzyme levels, human leukocyte antigen types, and CD4 Vα2.3+ T cells in BALF. Corticosteroids remain the mainstay of treatment for symptomatic patients with severely affected or declining organ function. Sarcoidosis is associated with a range of adverse long-term outcomes and complications, and with great variation in prognosis between populations. New data and technologies have moved sarcoidosis research forward, increasing our understanding of the disease. However, there is still much left to be discovered. The pervading challenge is how to account for patient variability. Future studies should focus on how to optimize current tools and develop new approaches so that treatment and follow-up can be targeted to individuals with more precision.

Download full-text PDF

Source
http://dx.doi.org/10.1111/joim.13629DOI Listing

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