Sarcoidosis is a multisystemic disease and its diagnostic difficulties

Abstract

The peculiarities of the clinical symptoms of sarcoidosis and complexity of its diagnosis have been considered on the clinical example of sarcoidosis manifestations in a young man. Sarcoidosis is a relatively rare multisystem inflammatory granulomatous disease of unknown etiology. The incidence of sarcoidosis varies according to different authors from 7.5 to 64 cases per 100.000 population. The clinical manifestations of sarcoidosis are determined by the number of affected organs, the degree of their structural and functional disorders, and the severity of general inflammatory symptoms. Mostly often, the process involves the intrathoracic lymph nodes, lungs, skin and eyes. Musculoskeletal involvement is rare; about 10 — 15 % of patients with sarcoidosis have associated arthropathy. In this article, special attention is paid to the importance of assessing the articular syndrome and visualization of the chest cavity organs, as well as assessing the dynamics of changes in the progression of the disease. The dynamic changes in laboratory parameters and instrumental diagnostic methods have been highlighted. The analysis of the literature data about sarcoidosis was carried out. The emphasis is stroked on the limitations of modern diagnostic methods, as well as the non‑specificity of clinical manifestations. A doctor can only rely on the results of histological studies or imaging using computed tomography or nuclear magnetic resonance imaging. It is noted that the symptom complex, known as Löfgren’s syndrome, manifests with a combination of skin manifestations, hilar lymphadenopathy and articular syndrome, and is very rare. In the presented clinical case, medrol 16 mg per day was used as a basic therapy. Therapy with glucocorticosteroids was associated with a good clinical and laboratory response, a decrease in the size of the mediastinal neoplasm, and an improvement in the patient’s well‑being.