The role of primary care in sarcoidosis

Abstract

Purpose of review The current review aims to highlight the role of primary care physicians in the diagnosis, treatment and monitoring of patients with sarcoidosis. Increased awareness of the clinical and imaging manifestations of the disease as well as the natural disease course will help for earlier and more accurate diagnosis as well as detection of high-risk patients who would benefit from treatment introduction. Recent findings Recent guidelines have attempted to deal with the confusion related to treatment indications, duration and monitoring of treatment in patients with sarcoidosis. Nonetheless, important points require further clarification. Primary care physicians may be the first to confront disease exacerbation, deterioration despite treatment and/or treatment-induced side effects. Furthermore, they are the physicians that remain closer to the patient providing a significant amount of information, psychological support and assessment for sarcoidosis-specific or not issues. The treatment strategy for each organ is complex, but the principles of treatment have been explored. Summary There have been considerable advances in the diagnostic and management approach of patients with sarcoidosis. Multidisciplinary approach for both diagnosis and management seems optimal. Validating risk stratification strategies and standardizing the monitoring process is appropriate for the future.

A Rare Case of Pulmonary Sarcoidosis With Extracranial Carotid System Involvement

“…Close to 30% of patients with sarcoidosis present with extrapulmonary involvement, which may be the primary manifestation of the disease or occur in isolation. [3][4][5] Involvement of cervical vessels is an uncommon manifestation and seldom described in the literature. This is a case report and literature review aiming to understand and highlight the need to assess possible extrapulmonary sites using multimodal imaging, as well as the monitoring of these sites after initiation of drug treatment, with a focus on ultrasound findings.…”

Achado Raro de Sarcoidose Pulmonar com Acometimento do Sistema Carotídeo Extracraniano

“…Fanilda Souto Barros, 1 Halsted Alarcão Gomes Pereira da Silva, 2,3 Daniela Souto Barros,4 Simone Nascimento dos Santos 5 Instituto Fanilda Barros,¹ Vitória, ES -Brasil Instituto Dante Pazzanese de Cardiologia,² São Paulo, SP -Brasil Hospital São Geraldo,³ Juína, MT -Brasil Hospital Santa Cruz, 4 Curitiba, PR -Brasil Eccos Diagnóstico Cardiovascular Avançado, 5 Brasília, DF -Brasil Introdução A sarcoidose é considerada uma doença de etiologia desconhecida, cuja patogênese parece envolver fatores genéticos, imunológicos, infecciosos e ambientais. Essa doença foi descrita pela primeira vez em 1889 por Ernest Besnier, sendo também denominada doença de Besnier-Boeck-Schaumann.…”

“…Cerca de 30% dos pacientes com sarcoidose apresentam envolvimento extrapulmonar, podendo ser a manifestação primária da doença ou, até mesmo, o único órgão acometido de forma isolada. [3][4][5] O acometimento de vasos cervicais é uma manifestação incomum e pouco descrita na literatura. Apresentamos um relato de caso e revisão da literatura, com foco na compreensão e necessidade de avaliação de possíveis sítios extrapulmonares por meio de imagem multimodal, assim como do acompanhamento desses sítios após o início do tratamento medicamentoso, dando ênfase para as alterações ultrassonográficas.…”