Abstract
As sarcoidosis may involve any organ, sarcoidosis patients should be evaluated for
occult disease. Screening for some organ involvement may not be warranted if it is
unlikely to cause symptoms, organ dysfunction, or affect clinical outcome. Even organ
involvement that affects clinical outcome does not necessarily require screening if
early detection fails to change the patient's quality of life or prognosis. On the
other hand, early detection of some forms of sarcoidosis may improve outcomes and
survival. This manuscript describes the approach to screening sarcoidosis patients
for previously undetected disease. Screening for sarcoidosis should commence with
a meticulous medical history and physical examination. Many sarcoidosis patients present
with physical signs or symptoms of sarcoidosis that have not been recognized as manifestations
of the disease. Detection of sarcoidosis in these instances depends on the clinician's
familiarity with the varied clinical presentations of sarcoidosis. In addition, sarcoidosis
patients may present with symptoms or signs that are not related to specific organ
involvement that have been described as parasarcoidosis syndromes. It is conjectured
that parasarcoidosis syndromes result from systemic release of inflammatory mediators
from the sarcoidosis granuloma. Certain forms of sarcoidosis may cause permanent and
serious problems that can be prevented if they are detected early in the course of
their disease. These include (1) ocular involvement that may lead to permanent vision
impairment; (2) vitamin D dysregulation that may lead to hypercalcemia, nephrolithiasis,
and permanent kidney injury; and (3) cardiac sarcoidosis that may lead to a cardiomyopathy,
ventricular arrhythmias, heart block, and sudden death. Screening for these forms
of organ involvement requires detailed screening approaches.
Keywords
sarcoidosis - screening - symptoms - cardiac - vitamin D
