Sarcoidosis diagnostics

Since the possible sarcoidosis symptoms are so diverse and sometimes unspecific, the diagnosis of sarcoidosis (Boeck's disease) is often not easy. In addition, the blood levels in the acute form of sarcoidosis and the chronic form of sarcoidosis differ. Often the diagnosis is based on the symptoms of the affected organ, often the diagnosis is made up of many pieces of the puzzle. The diagnosis of sarcoidosis is based not only on the medical history and physical examination but also on the following diagnostic measures.

Sarcoidosis: diagnostic measures

  • Chest X-ray: In relation to the involvement of the lung as the most frequently affected organ, a classification into stages is made on the basis of the X-ray image. There are usually five types (0 to IV), more rarely also three (I-III), ranging from a picture without pulmonary involvement to scarring of the lung tissue with corresponding loss of function.
  • Studies of lung function
  • Blood tests, urine tests
  • ECG, long-term ECG
  • Ophthalmological examination
  • Tuberculin test (to rule out tuberculosis, which also includes granulomas)
  • X-ray examination, computed tomography, magnetic resonance imaging of the head, examination of the nerve water
  • Detection of typical cells in the granulomas obtained by biopsy. However, since the granulomas are very small, their localization and tissue recovery is often not easy.

Sarcoidosis: delineate other diseases

If there is a suspicion of sarcoidosis, other diseases must be ruled out for a diagnosis. These include pulmonary involvement, tuberculosis, lung metastases and other lung diseases associated with scarring. In case of skin changes, sarcoidosis should be distinguished from diseases that can also cause erythema nodosum, for example Lyme disease or Crohn's disease.

Once the sarcoidosis diagnosis has been made, follow-up examinations must be carried out at regular intervals - especially in the first two years. How often is controlled depends on the therapy, the affected organs and the stages of sarcoidosis.

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