RESUMEN
Background: The diagnosis of sarcoidosis is not standardized but is based on three major criteria: a compatible clinical presentation, finding nonnecrotizing granulomatous inflammation in one or more tissue samples, and the exclusion of alternative causes of granulomatous disease. There are no universally accepted measures to determine if each diagnostic criterion has been satisfied; therefore, the diagnosis of sarcoidosis is never fully secure.Methods: Systematic reviews and, when appropriate, meta-analyses were performed to summarize the best available evidence. The evidence was appraised using the Grading of Recommendations, Assessment, Development, and Evaluation approach and then discussed by a multidisciplinary panel. Recommendations for or against various diagnostic tests were formulated and graded after the expert panel weighed desirable and undesirable consequences, certainty of estimates, feasibility, and acceptability.Results: The clinical presentation, histopathology, and exclusion of alternative diagnoses were summarized. On the basis of the available evidence, the expert committee made 1 strong recommendation for baseline serum calcium testing, 13 conditional recommendations, and 1 best practice statement. All evidence was very low quality.Conclusions: The panel used systematic reviews of the evidence to inform clinical recommendations in favor of or against various diagnostic tests in patients with suspected or known sarcoidosis. The evidence and recommendations should be revisited as new evidence becomes available.
Asunto(s)
Cardiomiopatías/diagnóstico , Enfermedades Renales/diagnóstico , Hepatopatías/diagnóstico , Sarcoidosis Pulmonar/diagnóstico , Alanina Transaminasa/sangre , Fosfatasa Alcalina/sangre , Aspartato Aminotransferasas/sangre , Biopsia , Broncoscopía , Calcio/sangre , Cardiomiopatías/sangre , Cardiomiopatías/fisiopatología , Creatinina/sangre , Ecocardiografía , Electrocardiografía , Electrocardiografía Ambulatoria , Endosonografía , Oftalmopatías/diagnóstico , Oftalmopatías/fisiopatología , Humanos , Hipercalcemia/sangre , Hipercalcemia/diagnóstico , Hipertensión Pulmonar/diagnóstico , Hipertensión Pulmonar/fisiopatología , Enfermedades Renales/sangre , Hepatopatías/sangre , Ganglios Linfáticos/patología , Linfadenopatía , Imagen por Resonancia Magnética , Mediastino , Tomografía de Emisión de Positrones , Neumología , Sarcoidosis/sangre , Sarcoidosis/diagnóstico , Sarcoidosis/patología , Sarcoidosis/fisiopatología , Sarcoidosis Pulmonar/sangre , Sarcoidosis Pulmonar/patología , Sarcoidosis Pulmonar/fisiopatología , Sociedades Médicas , Vitamina D/sangreRESUMEN
On April 7th and 8th, 2017; the Americas Association for Sarcoidosis and Other Granulomatous Diseases (AASOG) held its annual scientific conference titled "Combining Transformative Sarcoidosis Research and Outreach to Improve Health Disparities" at the Penn State Health, Hershey Campus Conference Center. Participants came from geographically diverse areas of the United States. The demographics of meeting speakers and attendees reflected the gender, racial and ethnic diversity of those who are engaged in the treatment of the disease. The AASOG meeting was held in conjunction with an FSR-sponsored sarcoidosis patient-physician conference, providing a unique forum to enhance communication between patients, providers and researchers. Cutting edge topics at the meeting included immunology, microbiome, genomics, and challenges in diagnosis and treatment of vulnerable populations. The meeting's clinical foci were neurosarcoidosis, fatigue, and small fiber neuropathy. (Sarcoidosis Vasc Diffuse Lung Dis 2018; 35: 91-94).
RESUMEN
The diagnosis of sarcoidosis is not standardized but is based on three major criteria: a compatible clinical presentation, finding nonnecrotizing granulomatous inflammation in one or more tissue samples, and the exclusion of alternative causes of granulomatous disease. There are no universally accepted measures to determine if each diagnostic criterion has been satisfied; therefore, the diagnosis of sarcoidosis is never fully secure. Systematic reviews and, when appropriate, meta-analyses were performed to summarize the best available evidence. The evidence was appraised using the Grading of Recommendations, Assessment, Development, and Evaluation approach and then discussed by a multidisciplinary panel. Recommendations for or against various diagnostic tests were formulated and graded after the expert panel weighed desirable and undesirable consequences, certainty of estimates, feasibility, and acceptability. The clinical presentation, histopathology, and exclusion of alternative diagnoses were summarized. On the basis of the available evidence, the expert committee made 1 strong recommendation for baseline serum calcium testing, 13 conditional recommendations, and best practice statement. All evidence was very low quality.The panel used systematic reviews of the evidence to inform clinical recommendations in favor of or against various diagnostic tests in patients with suspected or known sarcoidosis. The evidence and recommendations should be revisited as new evidence becomes available.