Introduction
In the diagnosis of sarcoidosis it is also important to distinguish between the acute and the chronic form of sarcoidosis. In any case, a comprehensive anamnesis interview as well as a physical examination by the treating physician should be performed first. If the presence of Löfgren’s syndrome is suspected, an X-ray of the lungs should be taken. Such an x-ray usually shows a bihilary lymphadenopathy very clearly. An x-ray can also be used to classify the lung, which is a good starting point for the preparation of a treatment plan.
What diagnostic tests are available?
Furthermore, a laboratory analysis of the blood should be requested. Here, the expression of an inflammatory reaction of the body results in increased inflammation values, a so-called “acute phase reaction” with increased C-reactive protein (CRP value) and increased blood sedimentation rate. In 65% of the cases, an increased activity of a certain enzyme, the so-called angiotension-converting enzyme, can be measured during a blood test.
However, this method has an uncertain specificity, i.e. an increase in the angiotension converting enzyme is also found in other diseases. Therefore, this parameter is particularly suitable for monitoring the course of the disease. Furthermore, a biopsy, i.e. a sample of the body’s own tissue, should be taken in order to be able to examine the individual granulomas and their cells in detail.
In this way, other diseases, which are also associated with nodulation, can often be excluded. It is important to know that sarcoidosis-type granulomas can also occur in tuberculosis and Crohn’s disease, an inflammatory bowel disease. If one suspects that the heart is affected, an ECG should be prepared to detect any cardiac arrhythmia.
These diagnostic criteria are
There are different criteria depending on the method used for diagnosis. On the one hand, the question of an acute existing inflammation and on the other hand the question of the localization of the sarcoidosis in different organs are in the foreground. There are also various parameters in the blood, such as calcium, which are also related to the progression and prognosis of the disease. In lung X-rays, the progress of the lung infestation is mainly assessed on the basis of the lymph nodes and changes in the lung tissue. It is also important to distinguish the acute form of sarcoidosis, Löfgren’s syndrome, from the chronic form.
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