| Korean Guidelines for Diagnosis and Management of Interstitial Lung Diseases: Park 7. Sarcoidosis |
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Eun Joo Lee1, Yangjin Jegal2, Dong Won Park3, Jimyung Park4, Jun-Pyo Myong5, Ji-Hyun Lee6, Bo Hyoung Kang7 |
1Division of Respiratory, Critical Care Medicine and Allergy, Korea University College of Medicine, Korea University Anam Hospital
2Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Ulsan University Hospital
3Division of Pulmonary and Critical Care Medicine, Hanyang University College of Medicine
4Division of Pulmonary and Critical Care Medicine, Seoul National University Hospital
5Department of Occupational and Environmental Medicine, Seoul St. Mary’s Hospital, College of Medicine, the Catholic University of Korea
6Department of Allergy, Pulmonary and Critical Care Medicine, CHA University, CHA Bundang Medical Center
7Division of Pulmonary and Critical Care Medicine, Dong-A University Hospital |
Correspondence:
Eun Joo Lee,
Email: nanjung@korea.ac.kr
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Received: 8 January 2025 • Revised: 28 February 2025 • Accepted: 31 March 2025 |
| Abstract |
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Sarcoidosis is a granulomatous inflammatory disease of unknown etiology that can affect the entire body, but respiratory tract involvement is most common. In radiological findings, bilateral hilar and mediastinal lymph node enlargement is the most common finding, and when lung parenchyma is involved, findings such as micronodules, ground-glass shadows, reticular shadows, and fibrosis are seen. Biopsies for histological diagnosis are mainly performed on lymph nodes or lungs, and mediastinal lymph node biopsies are done via endobronchochial ultrasound-guided fine needle aspiration. Pathological findings are characterized by non-caseating, non-necrotizing granulomas, and in Korea, differentiation from tuberculosis is especially important. The natural history of sarcoidosis is very variable, with approximately two-thirds of subjects showing spontaneous remission and only 10-30% of patients showing a chronic or progressive form. The most important factor in determining treatment is whether there is a risk of death, organ failure, or loss of quality of life. Glucocorticosteroids are the mainstay of treatment, and if the disease progresses despite treatment, or if glucocorticosteroids cannot be reduced or cannot be used, immunosuppressants such as methotrexate and azathioprine can be considered. Response to glucocorticosteroids treatment is good, and most of the patients stabilize or improve, with a low mortality rate around 3-5%. |
| Key Words:
Interstitial lung disease, Sarcoidosis, Diagnosis, Treatment |
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