The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Axial Spondyloarthritis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Interprofessional Perspective
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / 2015 ACR/ARHP Annual Meeting: Unknowns Persist Around Sarcoidosis Etiology, Pathogenesis, Treatment

2015 ACR/ARHP Annual Meeting: Unknowns Persist Around Sarcoidosis Etiology, Pathogenesis, Treatment

March 15, 2016 • By Thomas R. Collins

  • Tweet
  • Email
Print-Friendly Version / Save PDF
designer491/shutterstock.com

designer491/shutterstock.com

SAN FRANCISCO—The Kveim-Siltzbach skin test for a diagnosis of sarcoidosis was developed in 1941, then popularized in 1961. Since then, the knowledge base about the disease has not expanded much, said Kristin Highland, MD, who has dual appointments at Cleveland Clinic’s Respiratory Institute and Orthopedics and Rheumatology Institute.

You Might Also Like
  • 2014 ACR/ARHP Annual Meeting: Diagnosis, Management of Sarcoidosis in the Heart, Central Nervous System
  • 2015 ACR/ARHP Annual Meeting: RA Pathogenesis and Prevention
  • 2015 ACR/ARHP Annual Meeting: Behçet’s Disease Poses Diagnosis, Treatment Challenges
Explore This Issue
March 2016
Also By This Author
  • 2015 ACR/ARHP Annual Meeting: Latest Clinical Literature Offers New Strategies in Lupus Nephritis

“We don’t know a whole lot more since that time,” Dr. Highland said in a talk at the 2015 ACR/ARHP Annual Meeting. “We don’t know, really, the etiology or a detailed pathogenesis or standard treatment or a good method to assess therapy or a good method for follow-up.” This is despite thousands of published articles on sarcoidosis.

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

But enough is known about the disorder to give clinicians guidance on how to spot and how to treat the disease—if treatment is necessary, which it often is not.

Sarcoidosis—inflammation, thought to be brought about by airborne particles, that affects organs throughout the body, but mostly the lungs—is diagnosed when “clinicoradiological findings are supported by histological evidence of non-caseating epithelioid cell granulomas,” according to the American Thoracic Society. But “granulomas of known causes and local sarcoid reactions must be excluded.”

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

“So this is a diagnosis of exclusion,” Dr. Highland said.

The mortality, which is thought to have a genetic basis, is rising in the U.S., and so is the number of hospitalizations of people with sarcoidosis, although hospitalizations specifically due to sarcoidosis have plateaued, she said.1

Agents thought to bring about sarcoidosis include Myobacterium tuberculosis, fungi, viruses, beryllium, pine pollen, pesticides and agents associated with firefighting.

ad goes here:advert-3
ADVERTISEMENT
SCROLL TO CONTINUE

Dr. Highland stressed that if you’re thinking about a diagnosis of sarcoidosis in the lung, infections need to be ruled out and “a very careful review of systems” has to be undertaken to rule out etiologies more likely linked with hypersensitivity pneumonitis. In the case of other organs, lymphoma needs to be considered. Sometimes, therapy, including methotrexate, can bring about a granulomatous-type reaction that can be confused with sarcoidosis, she said.

A Tricky Diagnosis

The diagnosis, therefore, can be tricky. A review of new sarcoidosis referrals at her former center over a seven-month period found that one in six of the patients did not actually have sarcoidosis, Dr. Highland said.

Clues that should cause clinicians to suspect sarcoidosis include African-American race, female gender, symmetric bilateral hilar adenopathy and an asymptomatic presentation.

Another element making sarcoidosis a difficult-to-manage disease is that it “can affect virtually any organ that it wants to,” Dr. Highland said, although the lungs are involved in about 95% of cases. Deaths from sarcoidosis are most often due to lung, heart or central nervous system involvement.

Pages: 1 2 3 | Single Page

Filed Under: Conditions, Meeting Reports, Systemic Inflammatory Syndromes Tagged With: 2015 ACR/ARHP Annual Meeting, American College of Rheumatology, Diagnosis, Etiology, inflammatory, Pathogenesis, rheumatologist, Sarcoidosis, TreatmentIssue: March 2016

You Might Also Like:
  • 2014 ACR/ARHP Annual Meeting: Diagnosis, Management of Sarcoidosis in the Heart, Central Nervous System
  • 2015 ACR/ARHP Annual Meeting: RA Pathogenesis and Prevention
  • 2015 ACR/ARHP Annual Meeting: Behçet’s Disease Poses Diagnosis, Treatment Challenges
  • 2015 ACR/ARHP Annual Meeting: Better Pain Prevention, Treatment Needed for Older Adults

ACR Convergence

Don’t miss rheumatology’s premier scientific meeting for anyone involved in research or the delivery of rheumatologic care or services.

Visit the ACR Convergence site »

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2022 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)