Clinical features and diagnostic approach of sarcoidosis

Sarcoidosis is a multisystem disorder of unknown thiology. Patients with sarcoidosis present a variety of manifestations. The clinical feature of this disorder depends on age, gender and ethnicity of the patients, duration and activity of the illness, site and extent of organ involvement. In Japanese patients, ocular lesions as in prevalence cases showed a marked increase in recent years, while the proportion of patients with BHL or pulmonary involvement detected by chest X-ray mass survey was decreasing. Of symptoms at presentation, ocular symptom is most frequent and the following symptoms are skin manifestation, cough, general fatigue, fever and so on. Patients without symptoms at presentation are estimated as a quarter of patients. The diagnosis of sarcoidosis needs a compatible clinical feature and histologic demonstration of noncaseating granulomas. Additionally, other diseases presenting similar clinical pictures and/or pathologic findings should be excluded. In order to obtain a histologic confirmation of the disease and to assess extent, severity and activity of the disease, the further examinations for diagnostic work-up in patients with sarcoidosis are required after establishing clinical and radiological features.