Sarcoidosis
Non-caseating granulomas in lungs, nodes, skin, eyes and heart. Löfgren syndrome, the baseline screen every patient needs (ECG, calcium, creatinine, eyes), when to biopsy by EBUS, who to treat, and the 2025 shift towards methotrexate and shorter steroid courses (PREDMETH).
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Multisystem disease with non-caseating granulomas. Lungs and intrathoracic nodes in over 90%; skin, eyes, joints, heart, nervous system and kidneys less often.
- A diagnosis of compatible clinical picture plus granulomas plus exclusion of TB, fungi, lymphoma, drugs and beryllium.
- Many never need treatment. Treat when organs or quality of life are threatened. Heart, eye, CNS and hypercalcaemia always need specialist input.
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Sources
- Crouser ED et al. Diagnosis and detection of sarcoidosis. An official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med 2020;201:e26-e51American Thoracic Society, 2020
- Baughman RP et al. ERS clinical practice guidelines on treatment of sarcoidosis. Eur Respir J 2021;58:2004079European Respiratory Society, 2021
- Thillai M et al. BTS clinical statement on pulmonary sarcoidosis. Thorax 2021;76:4-20British Thoracic Society, 2021
- Grunewald J, Eklund A. Löfgren's syndrome: human leukocyte antigen strongly influences the disease course. Am J Respir Crit Care Med 2009;179(4):307-12American Thoracic Society, 2009
- Kahlmann V et al. First-line treatment of pulmonary sarcoidosis with prednisone or methotrexate (PREDMETH). N Engl J Med 2025;393:231-42New England Journal of Medicine, 2025
- Wells AU et al. A paradigm shift in corticosteroid therapy for sarcoidosis (WASOG position paper). Lancet Respir Med 2026;14:363-74World Association of Sarcoidosis and Other Granulomatous Disorders, 2026 (online November 2025)
- Cheng RK et al. Diagnosis and management of cardiac sarcoidosis: a scientific statement from the American Heart Association. Circulation 2024;149:e1197-e1216American Heart Association, 2024
- Miedema JR et al. Sarcoidosis: a state-of-the-art review. Eur Respir J 2026;67:2501324European Respiratory Journal, 2026
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy