Self-Study Resources-Sarcoidosis: Diagnosing and Managing Pulmonary, Endobronchial, and Cardiac Manifestations

Video Transcription

Video Summary

The video highlights the diagnosis and management of sarcoidosis, with a focus on pulmonary manifestations. It mentions the lack of a specific diagnostic test for sarcoidosis and the use of diagnostic algorithms. Imaging techniques such as chest x-rays and gallium scans are discussed to aid in diagnosis. Tissue diagnosis is emphasized to confirm sarcoidosis and exclude other granulomatous processes. Staging of sarcoidosis and the use of CT scans for staging and prognosis are also mentioned, along with patterns of abnormalities seen on high-resolution CT scans. The importance of bronchoscopy and lymph node sampling for diagnosis is briefly touched upon.<br /><br />In terms of treatment, steroids are deemed necessary but long-term use is associated with side effects. Methotrexate is introduced as a second-line agent with steroid-sparing effects. Other second-line agents such as azathioprine and leflunomide are briefly mentioned. Biologic agents, specifically infliximab, are discussed as third-line options with effectiveness in pulmonary and extrapulmonary sarcoidosis.<br /><br />Regarding airway manifestations in sarcoidosis, various abnormalities such as nodules, stenosis, plaques, and increased vascularity can occur. Plaque formation is the most common abnormality associated with endobronchial sarcoidosis. Bronchial stenosis can occur, particularly in the right middle and upper lobes. Bronchiolitis is also a common finding, which can lead to air trapping and mosaicism on CT scans. Bronchoscopy, with transbronchial lung biopsies and endobronchial ultrasound with transbronchial needle aspiration, is recommended for diagnosis. Management involves systemic treatment with steroids or steroid-sparing agents. Balloon bronchoplasty can be considered for significant multi-level airway stenosis, while interventions like laser treatment and standard injections may be used in certain cases. Stenting is typically a last resort.

Meta Tag

Category Diffuse Lung Disease

Session ID 2017

Speaker Randal Goldberg

Speaker Kerry Hena

Speaker Marc Judson

Speaker Alberto Revelo

Track Diffuse Lung Disease

Keywords

sarcoidosis

diagnosis

management

pulmonary manifestations

imaging techniques

tissue diagnosis

staging

bronchoscopy

steroids

biologic agents