Sarcoidosis

• multisystem granulomatous disorder of unknown cause
• asso: with HLA-DRB1 and DQB1
• higher incidence among blacks and age 20-40

Two distinct sarcoid syndromes with acute presentation:

1. Löfgren syndrome - LoFj(g)rEN syndrome = Lymph node, Fever, joint pain, and erythema nodosum
2. Heerfordt-Waldenstrom syndrome - fever, parotid enlargement, uveitis, and facial palsy (called uveoparotid fever)

Hilar and left paratracheal adenopathy is the most common presentation in sarcoidosis.

15-20% of patients w/ sarcoidosis can have ocular involvement, and from these patients, 5% will have it as the primary presenting symptom. (most common - anterior uveitis)

Bone X-rays show "punched out" lesions in terminal phalanges

Sarcoidosis CXR

Stages:

• 1 = BHL
• 2 = BHL + infiltrates
• 3 = peripheral infiltrates (reticulonodular parenchyma) alone
• 4 = fibrosis

BHL alone don't need treatment

Differential Diagnoses of BHL