Because the possible sarcoidosis symptoms are so varied and sometimes nonspecific, the diagnosis of sarcoidosis (Boeck’s disease) is often not easy. In addition, the blood values also differ in the acute form of sarcoidosis and the chronic form of sarcoidosis. Often the diagnosis is based on the symptoms of the affected organ, often the diagnosis is only composed of many pieces of the puzzle. To establish the diagnosis of sarcoidosis, in addition to the medical history and physical examination, the following diagnostic measures contribute most.
Sarcoidosis: diagnostic measures.
- X-ray of the chest: with regard to the involvement of the lungs as the most frequently affected organ, a classification into stages is made on the basis of the X-ray. Five types (0 to IV) are usually distinguished, and more rarely three (I-III), ranging from an image without lung involvement to scarring of the lung tissue with corresponding loss of function.
- Examinations of lung function
- Blood tests, urine tests
- ECG, long-term ECG
- Ophthalmological examination
- Tuberculin test (to rule out tuberculosis, in which granulomas are also present).
- X-ray examination, computed tomography, magnetic resonance imaging of the head, examination of the nervous fluid.
- Detection of typical cells in the granulomas obtained by biopsy. However, because the granulomas are very small, their localization and tissue extraction is often not easy.
Sarcoidosis: delineate other diseases
If sarcoidosis is suspected, other diseases must be excluded for a diagnosis. These include tuberculosis, pulmonary metastases and other lung diseases associated with scarring if there is lung involvement. In the case of skin lesions, diseases that can also cause erythema nodosum, such as Lyme disease or Crohn’s disease, should be delineated in addition to sarcoidosis.
Once the diagnosis of sarcoidosis has been made, control examinations must be carried out at regular intervals – especially in the first two years. What is checked and how often depends on the therapy, the organs affected, and the stages of sarcoidosis.
