ATS GUIDELINES Bundle

Sarcoidosis

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18 Diagnosis Clinical presentation e figure outlines a general approach to the diagnosis of sarcoidosis and refers to tables presented with this article. Highly supportive of sarcoidosis: • Löfgren's syndrome • Lupus pernio • Heerfordt's syndrome • Bilateral hilar adenopathy (BHA), no symptoms Clinical presentation supportive of sarcoidosis Figure 3. Schematic of recommended diagnostic algorithm Consistent with sarcoidosis: (Table 1) Biopsy recommended? See PICOs1-3 Biopsy performed? YES Negative YES NO Probable sarcoidosis Consider alternative diagnosis Not consistent with sarcoidosis (Table 2) Positive and consistent with sarcoidosis (Table 2) Probable sarcoidosis For BHA, consider biopsy See PICO 1 Other causes for granulomas excluded (Table 3) Probable sarcoidosis NO

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