An Unusual Presentation of New Onset Sarcoidosis.
Sarcoidosis is a multi-system inflammatory disease with an unknown etiology that impacts quality of life and can lead to end organ failure. Sarcoidosis can be difficult to diagnose because its clinical presentation can reflect an array of varying etiologies, such as tuberculosis, lupus, idiopathic uveitis, and granulomatosis with polyangiitis.
It is important to identify sarcoidosis to provide appropriate treatment that targets its pathogenesis of the inflammatory formation of non-caseating granulomas. Sarcoidosis can commonly present with fatigue, fever, weight loss, cough, dyspnea, chest pain, uveitis, erythema nodosum, and joint arthritides.
Its initial presentation can be asymptomatic and be detected incidentally on chest X-ray.
There are varying tests that can help guide a diagnosis for sarcoidosis. These
include: laboratory tests, such as angiotensin-converting enzyme levels,
radiographs, such as chest X-rays demonstrating bilateral perihilar lymphadenopathy, and histopathology showing non-caseating granulomas.
Once diagnosed, first-line treatment for sarcoidosis is prednisone. Second-line treatments include methotrexate or hydroxychloroquine, and third-line treatments include infliximab or adalimumab.
The patient is a 73-year-old male with a past medical history of diastolic heart failure, atrial fibrillation, cerebral vascular accident/transient ischemic attack, Type 2 diabetes mellitus, hypertension and hyperlipidemia who was brought to the emergency department by family
due to confusion, light-headedness, nausea and vomiting for the past two-days.
Pulm Res Respir Med Open J. 2023; 6(1): 1-3. doi: 10.17140/PRRMOJ-6-140