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To exclude sarcoidosis in a case presenting with pulmonary symptoms might involve a chest radiograph, CT scan of chest, PET scan, CT-guided biopsy, mediastinoscopy, open lung biopsy, bronchoscopy with biopsy, endobronchial ultrasound, and endoscopic ultrasound with fine-needle aspiration of mediastinal lymph nodes (EBUS FNA).
Löfgren syndrome is a type of acute sarcoidosis, [1] an inflammatory disorder characterized by swollen lymph nodes in the chest, tender red nodules on the shins, fever and arthritis. [2] It is more common in women than men, and is more frequent in those of Scandinavian , Irish , African and Puerto Rican heritage.
Approximately 5–10 percent of people with sarcoidosis of other organs (e.g. lung) develop central nervous system involvement. Only 1 percent of people with sarcoidosis will have neurosarcoidosis alone without involvement of any other organs. Diagnosis can be difficult, with no test apart from biopsy achieving a high
Symptoms tend to be brief, but can range from mild to severe and include: fever, vomiting, increased respirations or difficulty breathing, cough, wheeze, and rash. Symptoms typically follow an exposure to allergens or certain drugs, and last approximately two weeks. [3] Eosinophilia is the main feature of diagnostic criteria for Loffler's syndrome.
In people who have lung disease prior to a diagnosis of CVID, the differential diagnosis includes sarcoidosis. Sarcoid is also characterised by granulomatous involvement of the lung and therefore patients being investigated for sarcoid should have serum immunoglobulins measured to exclude CVID. [citation needed]
Sarcoidosis, like berylliosis, also produces granulomas without a necrotic core, and so distinction between the two processes can be difficult. Ultimately, this process leads to restrictive lung disease (a decrease in diffusion capacity). The earliest symptoms are typically cough and shortness of breath. [5]
CT scan of the chest showing bilateral lymphadenopathy in the mediastinum due to sarcoidosis. Bilateral hilar lymphadenopathy is a bilateral enlargement of the lymph nodes of pulmonary hila. It is a radiographic term for the enlargement of mediastinal lymph nodes and is most commonly identified by a chest x-ray.
The differential diagnosis includes other types of lung disease that cause similar symptoms and show similar abnormalities on chest radiographs. Some of these diseases cause fibrosis, scarring or honeycomb change. The most common considerations include: chronic hypersensitivity pneumonitis; non-specific interstitial pneumonia; sarcoidosis