Diagnosis of sarcoidosis.
ABSTRACT To describe the recent advances in the diagnostic procedures for sarcoidosis and explore future directions.
Novel imaging techniques have been explored in sarcoidosis, such as positron emission tomography using L-[3-F]-alpha-methyltyrosine, which is more specific for malignancy than F-fluorodeoxyglucose positron emission tomography. The combined modality of L-[3-F]-alpha-methyltyrosine-positron emission tomography with fluorodeoxyglucose-positron emission tomography could successfully discriminate sarcoidosis from malignancy. The finding of delayed enhancement in cardiac magnetic resonance imaging could identify cardiac involvement of sarcoidosis with higher sensitivity than echocardiography, thallium scintigraphy, and gallium scintigraphy. Endobronchial ultrasonograpy-guided transbronchial needle aspiration is a safe and useful tool for diagnosing sarcoidosis with a diagnostic accuracy, sensitivity and specificity of 85-93, 78-89, and 92-96%, respectively. Developments in genetics have demonstrated that 99% of the human leukocyte antigen DRB1*0301/DQB1*0201-positive patients with Löfgren's syndrome show a spontaneous remission, in contrast to only 55% of the human leukocyte antigen DRB1*0301/DQB1*0201-negative patients. These alleles could be novel promising factors for discriminating a prognosis in Löfgren's syndrome.
Recent development including novel imaging techniques, novel biopsy procedures, and genetic analyses could be of value for the diagnosis of sarcoidosis.
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ABSTRACT: Sarcoidosis commonly involves the lungs but also not uncommonly presents as uveitis, arthritis, myositis or neurologic disease. Recognition of the presenting features, organ complications, and immunopathogenesis is important for timely diagnosis and appropriate management. Current studies support the disorder developing as a consequence of a CD4+ T-cell-mediated response to variable environmental or microbial triggers in the context of one or more determined susceptibility genes including BTNL2, with other genes such as CARD15/NOD2, governing disease severity. Magnetic resonance imaging (MRI) is useful in defining the presence and extent of central nervous system (CNS), osseous, and both skeletal and cardiac muscle disease. Corticosteroids remain the mainstay of therapy; patients with refractory disease may respond to other immunomodulating drugs, including anti-TNF-alpha antibodies but the optimal roles of traditional immunomodulating as well as newer biologic therapies in management are continuing to be defined. Insights into triggering immune events and susceptibility genes should provide potential new strategies and targets for therapy. The judicious use of MRI in suspected cases can enhance earlier recognition of disease in the CNS, bone, and both skeletal and cardiac muscle to guide diagnostic procedures as well as appropriate treatment.Current opinion in rheumatology 10/2009; 22(1):85-90. · 4.60 Impact Factor
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ABSTRACT: Sarcoidosis is a multisystem granulomatous disease of unknown etiology. The diagnosis is based on clinical and radiographic findings as well as by histopathological findings. Molecular imaging in recent years has made important progress regarding the study of various inflammatory diseases including sarcoidosis. Positron emission tomography (PET) provides an insight in metabolism of this disease. Positron emission tomography with fluorine-18-fluorodeoxyglucose ((18)F-FDG) has shown effectiveness in detecting occult disease and assessing disease activity during treatment. This review article provides an overview of the applications of PET/computed tomography and PET/ magnetic resonance imaging for evaluation of patients with sarcoidosis.Hellenic journal of nuclear medicine 05/2014; 17(2):123-35. · 0.68 Impact Factor
- Digestive and Liver Disease - DIG LIVER DIS. 01/2011; 43.