Diagnosis and management of pulmonary sarcoidosis: case report with literature review
DOI:
https://doi.org/10.11606/issn.1679-9836.v103i6e-228313Keywords:
Pulmonary Sarcoidosis, Non-caseating Granulomas, Lung Disease , Inflammatory DiseaseAbstract
Pulmonary sarcoidosis is a complex multisystem disorder characterized by the formation of non-caseating granulomas in affected organs, most commonly the lungs. This case report presents a patient diagnosed with pulmonary sarcoidosis following a clinical evaluation that included imaging studies and histopathological examination. The patient exhibited symptoms such as persistent cough and shortness of breath, which were initially attributed to a respiratory infection. However, further diagnostic workup revealed bilateral hilar lymphadenopathy and lung parenchymal involvement, raising suspicion for sarcoidosis. The lung and lymph node biopsy confirmed the presence of non-caseating granulomas, leading to a definitive diagnosis. This report highlights the importance of considering sarcoidosis in the differential diagnosis of unexplained respiratory symptoms and discusses the clinical and imaging findings that guided the diagnosis. Early recognition and appropriate management are essential to prevent complications associated with this chronic inflammatory disease.Downloads
References
Soares BB, Torquato JL, Marinho LN, Rego JDB, Silva JF, Sá DM, Dias FSL, Soares PB, Correa TM, Orben TA. Sarcoidosis, a diagnostic challenge case report. Int J Health Sci. 2022;2(60). Doi: 10.22533/at.ed.1592602211107.
Drent M, Crouser ED, Grunewald J. Challenges of Sarcoidosis and Its Management. N Engl J Med. 2021;385(11):1018-32. Doi: 10.1056/NEJMra2101555.
Arkema EV, Cozier YC. Sarcoidosis epidemiology: recent estimates of incidence, prevalence and risk factors. Curr Opin Pulm Med. 2020;26(5):527-34. Doi: 10.1097/MCP.0000000000000715.
Grunewald J, Grutters JC, Arkema EV, Saketkoo LA, Moller DR, Muller-Quernheim J. Sarcoidosis. Nat Rev Dis Primers. 2019;5(1):45. Doi: 10.1038/s41572-019-0096-x.
Llanos O, Hamzeh N. Sarcoidosis. Med Clin North Am. 2019;103(3):527-34. Doi: 10.1016/j.mcna.2018.12.011.
King TE Jr, Culver DA, Flaherty KR, Muller NL, Dieffenbach P. Clinical manifestations and diagnosis of sarcoidosis. UpToDate. 2024. https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-sarcoidosis.
Spagnolo P, Rossi G, Trisolini R, Sverzellati N, Baughman RP, Wells AU. Pulmonary sarcoidosis. Lancet Respir Med. 2018;6(5):389-402. Doi: 10.1016/S2213-2600(18)30064-X.
Rodrigues SL, Freixo B, Aguiar AT, Coutada A, Leal C, Duarte H. Sarcoidose da Mama: Uma Manifestação Incomum. Acta Radiol Port. 2023;35(2):1-8. Doi: 10.25748/arp.27792.
Judson MA. Strategies for identifying pulmonary sarcoidosis patients at risk for severe or chronic disease. Expert Rev Respir Med. 2017;11(2):111-8. Doi: 10.1080/17476348.2017.1281745.
Baughman RP, Wells A. Advanced sarcoidosis. Curr Opin Pulm Med. 2019;25(5):497-504. Doi: 10.1097/MCP.0000000000000612.
Judson MA. Endpoints in sarcoidosis: more like IPF or asthma? Respir Med. 2018;138S. Doi: 10.1016/j.rmed.2017.11.010.
Baughman RP, Lower EE. Sarcoidose. In: Loscalzo J, Fauci A, Kasper DL, Hauser SL, Longo DL, Jameson J, et al., editors. Medicina Interna de Harrison. 21st ed. McGraw-Hill Education; 2023. https://accessartmed.mhmedical.com/content.aspx?bookid=3295§ionid=284459003.
Campos Roubert I, André dos Santos Vaz R. Sarcoidose: relato de caso. Rev Saude. 2021;12(2):22-7. Doi: 10.21727/rs.v12i2.2725.
Ferreira IF, Maia LDM, Moreira DF, Requeijo MJR. Radiological aspects of pulmonary sarcoidosis: An integrative review of the literature. Res Soc Dev. 2023;12(12):e75121244023. Doi: 10.33448/rsd-v12i12.44023.
Hamblin M, Prosch H, Vašáková M. Diagnosis, course and management of hypersensitivity pneumonitis. Eur Respir Rev. 2022;31:210169. Doi: 10.1183/16000617.0169-2021.
Marruchella A, Perrotti A, Ricciardi L, Troiano C, Maniscalco P, Gelfusa C, et al. Concurrent features of sarcoidosis and hypersensitivity pneumonitis in two patients exposed to fungal antigens. BMC Pulm Med. 2023;23:427. Doi: 10.1186/s12890-023-02642-x.
Grutters JC, van den Bosch JM, Drent M. La sarcoïdose: radiologie et diagnostic. Rev Mal Respir. 2017;34(1):10-22. Doi: 10.1016/j.rmr.2016.06.004.
Sève P, Pacheco Y, Durupt F, Jamilloux Y, Gerfaud-Valentin M, Isaac S, et al. Sarcoidosis: A Clinical Overview from Symptoms to Diagnosis. Cells. 2021;10:766. Doi: 10.3390/cells10040766.
Benzaquen S, Matta A, Sultan S, Sarvottam K. Role of bronchoscopy in diagnosis of sarcoidosis. Clin Chest Med. 2024;45(1):25-32. Doi:10.1016/j.ccm.2023.08.001.
Albakri M, Ahmad M, Mohamed MFH. Rapidly recurring massive pleural effusion as the initial presentation of sarcoidosis: a case report. Medicine (Baltimore). 2021;100(6):e24027. Doi:10.1097/MD.0000000000024027.
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Copyright (c) 2024 Laura Olivia Tavares Souto, William Alves de Souza Schwartz , Anna Luiza Menezes Ribeiro, Maíra Rocha Machado de Carvalho, Lara Fabiana Maia de Oliveira , Arthur Mineli Kuester Berto, Pedro Henrique Tarter Nunes, Lucas Ribeiro Miranda, Laura Barcelos Azzam
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