Validation of systemic parameters for the diagnosis of ocular sarcoidosis

Progress in the diagnosis of ocular sarcoidosis

“…[ 39 40 ] In the diagnosis of ocular sarcoidosis, KL-6 has a lower sensitivity than soluble interleukin 2 receptor (sIL2R) in one study, but has high specificity. [ 12 ] Due to its function as a lung protein, it is elevated non-specifically in settings of interstitial pneumonia and pulmonary fibrosis; thus, it is also elevated in pulmonary tuberculosis and thus likely has limited utility in distinguishing between sarcoidosis and tuberculosis. [ 41 ]…”

“…They calculated the Youden Index, an integration of both sensitivity and specificity, and noted a better Youden index for sIL2R (0.70) than for ACE (0.35), KL-6 (0.26), and Ca (0.07). [ 12 ]…”

“…As it is produced by epithelioid cells derived from macrophages in granulomas, it is thought to signify the burden of granulomas in the body. [ 12 24 51 52 ]…”

“…ACE and lysozyme levels continue to be useful, but serum soluble IL2 receptor levels may be more useful, especially prior to ordering radiographic studies. [ 12 ] If sIL2R levels are elevated, a high-resolution chest CT scan may be warranted to get an adequate level of detail to evaluate for parenchymal disease, lymphadenopathy, or fissural nodules consistent with sarcoidosis, along with a complete blood count to identify lymphopenia to assist in differentiation sarcoidosis from other diseases involving the lungs. [ 37 ]…”

“…[ 10 ] The latter criteria from 2019 demonstrated an improvement in sensitivities in two reports but have yet to be studied in a diverse international population. [ 11 12 ]…”