Investigations

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Hypercalcemia (high calcium levels) and its symptoms may be the result of excessive vitamin D production.

Sarcoidosis most often manifests as a restrictive disease of the lungs, causing a decrease in lung volume and decreased compliance (the ability to stretch). The disease typically limits the amount of air drawn into the lungs, but produces higher than normal expiratory flow ratios. The vital capacity (full breath in, to full breath out) is decreased, and most of this air can be blown out in the first second. This means the FEV1/FVC ratio is increased from the normal of about 80%, to 90%. Obstructive lung changes, causing a decrease in the amount of air that can be exhaled, may occur when enlarged lymph nodes in the chest compress airways or when internal inflammation or nodules impede airflow.

Chest X-ray changes are divided into four stages

* Stage 1 bihilar lymphadenopathy
* Stage 2 bihilar lymphadenopathy and reticulonodular infiltrates
* Stage 3 bilateral infiltrates
* Stage 4 fibrocystic sarcoidosis typically with upward hilar retraction, cystic & bullous changes

Because sarcoidosis can affect multiple organ systems, follow-up on a patient with sarcoidosis should always include an EKG, ophthalmologic exam, liver function tests, serum calcium and 24hour urine calcium.

Sarcoidosis
Sarcoidosis is a rare immune mediated condition which can involve many different organs. This article outlines current understanding, diagnosis and treatment.

Eye Problems - Sarcoidosis...
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Eye Problems - Investigations...
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