Extrapulmonary Sarcoidosis

["Author photo]Sarcoidosis is a multiorgan disease, affecting the lung in 90% of patients. Almost all patients diagnosed with sarcoidosis are eventually seen by a pulmonologist. The care of most patients with sarcoidosis is directed by the pulmonologist, who may become the patient's primary caregiver because any particular clinical problem is assumed to be due to sarcoidosis. In the case of skin or eye involvement, this may be fairly straightforward. For the patient with known sarcoidosis who has palpitations, headache, sinus symptoms, or nephrolithiasis, the clinician has to consider sarcoidosis as a possible cause. In patients with extrapulmonary sarcoidosis, there are many treatment issues. In some cases, therapy may last for years.

In this issue, we discuss various extrapulmonary manifestations of sarcoidosis. Our goal is to provide a useful resource for the clinician evaluating a patient for possible organ involvement. Each of the chapters reviews the manifestations of the disease, as well as the methods of determining organ involvement. For the skin, this may require a simple examination. For the heart or the brain, more elaborate testing may be required to detect disease.

The treatment of extrapulmonary disease is discussed to varying degrees by each of the authors. In addition, we have summarized the approach to the treatment of extrapulmonary disease as well as the various therapeutic agents, including information about mechanisms of action, toxicity, and efficacy of these drugs. Unfortunately, the published literature on the treatment of sarcoidosis remains limited, especially for extrapulmonary disease.

Extrapulmonary sarcoidosis is an important manifestation of sarcoidosis. We hope these articles help in the diagnosis and management of this disease.