Diagnostic tests

Because no specific diagnostic test exists, sarcoidosis is a diagnosis of exclusion. Evaluation of a patient for sarcoidosis may include1,12:

• Detailed history and physical: emphasis on lungs, skin, eyes, nervous system and heart

• Chest radiograph:

Stage 1: bilateral hilar with or without paratracheal adenopathy

Stage 2: adenopathy with pulmonary infiltrate

Stage 3: pulmonary infiltrates only Stage 4: pulmonary fibrosis

• Pulmonary function tests: restrictive pattern with decreased diffusing capacity (DLCO)

• Biopsy of affected tissue: demonstrates non-caseating granulomas

• Serum chemistry: elevated alkaline phosphatase and/or hypercalcaemia may be found, but these are not specific for sarcoidosis

• Angiotensin converting enzyme (ACE):

measurement is generally not a useful guide for diagnosis or therapeutic response

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