Advancing Sarcoidosis Diagnostics: A Comprehensive Exploration of Modern Approaches and Challenges
Since the possible sarcoid symptoms are so diverse and sometimes unspecific, diagnosing sarcoid (Boeck’s disease) is often challenging. In addition, the blood values differ in the acute and chronic forms of sarcoid. The diagnosis is often based on the symptoms of the affected organ, and the diagnosis is often made up of many pieces of the puzzle. In addition to the medical history and physical examination, the following diagnostic measures contribute to the diagnosis of sarcoidosis.
Sarcoidosis: diagnostic measures
- X-ray of the chest: A classification into stages is made based on the X-ray image about the involvement of the lungs as the most frequently affected organ. A distinction is usually made between five types (0 to IV), more rarely three (I-III), ranging from a picture without lung involvement to scarring of the lung tissue with corresponding functional losses.
- Lung function studies
- Blood tests, urine tests
- ECG, long-term ECG
- Ophthalmological examination
- Tuberculin test (to rule out tuberculosis, which also includes granulomas)
- X-ray examination, computer tomography, magnetic resonance imaging of the head, examination of the cerebrospinal fluid
- Detection of typical cells in the granulomas obtained by biopsy. However, since the granulomas are very small, localizing them and obtaining tissue is often challenging.
Sarcoidosis: differentiating other diseases
If sarcoidosis is suspected, other diseases must be ruled out for a diagnosis. In the case of lung involvement, these include tuberculosis, lung metastases and other lung diseases that are associated with scarring. In the case of skin changes, in addition to sarcoidosis, diseases that can also cause erythema nodosum, such as Lyme disease or Crohn’s disease, should be differentiated.
Once the diagnosis of sarcoidosis has been made, check-ups must be carried out at regular intervals – especially in the first two years. What is checked and how often depends on the therapy, the affected organs and the stages of the sarcoid.
