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Treatment of pulmonary sarcoidosis: Initial therapy with glucocorticoids

Talmadge E King, Jr, MD
Section Editor
Kevin R Flaherty, MD, MS
Deputy Editor
Helen Hollingsworth, MD


Sarcoidosis is a multisystem disease of unknown etiology characterized by tissue infiltration with noncaseating granulomas. The granulomas may occur in any organ, but the most frequently affected sites are the lungs, lymph nodes, skin, eyes, and liver. Patients with pulmonary sarcoidosis are most often asymptomatic at presentation. When symptomatic, patients usually report dyspnea, cough, or nonspecific chest discomfort. Spontaneous resolution of the disease is common, but progressive lung disease occurs in approximately 25 percent and disabling organ failure in up to 10 percent [1-3].

Glucocorticoids (also called corticosteroids) have long been the most commonly used agents for the treatment of pulmonary sarcoidosis, as they appear to attenuate the granulomatous inflammatory process. The key questions regarding the treatment of sarcoidosis with glucocorticoids are the following:

What are the indications for treatment?

When should therapy be started?

What is the optimal duration of therapy?

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Literature review current through: Dec 2017. | This topic last updated: Jan 25, 2017.
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