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ATS Issues Guideline on the Diagnosis of Sarcoidosis

Recommendations address the uncertainties faced by clinicians in the detection, diagnosis of sarcoidosis

doctor listening to lungs

MONDAY, May 4, 2020 (HealthDay News) -- In an official American Thoracic Society clinical practice guideline, published online April 15 in the American Journal of Respiratory and Critical Care Medicine, recommendations are presented for the detection and diagnosis of sarcoidosis.

Elliott D. Crouser, M.D., from the Ohio State University in Columbus, and colleagues reviewed the evidence to develop recommendations for or against various diagnostic tests for sarcoidosis.

Based on the available evidence, which was all very low quality, the researchers made one strong recommendation, 13 conditional recommendations, and one best practice statement. Baseline serum calcium testing is strongly recommended to screen for abnormal calcium metabolism for patients with sarcoidosis without symptoms or signs of hypercalcemia. Sampling lymph nodes is not suggested for patients for whom there is a high clinical suspicion for sarcoidosis; no recommendation is made for or against obtaining a lymph node sample for patients presenting with asymptomatic, bilateral hilar lymphadenopathy. A baseline eye examination is suggested for patients with sarcoidosis who do not have ocular symptoms. Baseline serum creatinine testing to screen for renal sarcoidosis is suggested for patients with sarcoidosis who have neither renal symptoms nor established renal sarcoidosis.

"Committee members concur that there is a pressing need for higher-quality evidence to guide clinical practice relating to the diagnosis and detection of sarcoidosis, and to better define the natural history of disease progression in each organ system," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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