Clinical Manifestations of Sarcoidosis

Pulmonary

Hilar LAN; fibrosis; pulm hypertension. Stages: I = bilat hilar

LAN; II = LAN + ILD; III = ILD only; IV = diffuse fibrosis.

Cutaneous (~15%)

Waxy skin plaques; lupus pernio (violaceous facial lesions)

Erythema nodosum (red tender nodules due to panniculitis, typically on shins). Ddx: idiopathic (34%), infxn (33%, strep, TB), sarcoid (22%), drugs (OCP, PCNs), vasculitis (Behçet’s), IBD, lymphoma.

Ocular (10–30%)

Anterior >posterior uveitis; ↑ lacrimal gland

Endo & renal (10%)

Nephrolithiasis, hypercalcemia (10%), hypercalciuria (40%) Due to vitamin D hydroxylation by macrophages

Neuro (10% clin, 25% path)

CN VII palsy, periph neuropathies, CNS lesions, seizures

Cardiac (5% clin, 25% path)

Conduction block, VT, CMP

Liver, spleen, BM

Granulomatous hepatitis (25%), splenic & BM gran. (50%)

Constitutional

Fever, night sweats, anorexia & wt loss (a/w hepatic path)

Musculoskeletal

Arthralgias, periarticular swelling, bone cysts