| Abstrakt: |
Sarcoidosis is a rare multiorgan granulomatous disease of unknown etiology, mostly affecting young adults, with predilection for hilar lymph nodes and the lung. Despite clinical and histologic similarities between sarcoidosis and tuberculosis, the role of M. tuberculosis in the etiopathogenesis of sarcoidosis is still not clear. Over recent years numerous studies identifying peripheral blood T-cell response to various mycobacterial antigens were published. In parallel, there is no direct evidence for the role of alive M. tuberculosis in the development of sarcoidosis, as evidenced by negative culture in these patients. Exclusion of active tuberculosis as the granulomatous disease of known cause, still remain the important step in diagnostic work-up in sarcoidosis. Development of bronchoscopic techniques significantly reduced the number of surgical procedures. Combination of a few biopsy techniques: transbronchial needle aspiration, endobronchial biopsy and transbronchial lung biopsy, can achieve the optimum diagnostic yield. Because of the large percentage of spontaneous remission in sarcoidosis, the decision of treatment should be taken with caution. Corticosteroids still remain first-line therapy in sarcoidosis. Methotrexate is the most commonly used second-line drug. TNFα-antagonists are the therapeutic option in refractory sarcoidosis. In this article we summarise the present knowledge about the most common localization of sarcoidosis - pulmonary sarcoidosis, with special emphasis on the current etiologic hypothesis, possibility of diagnosis and treatment. |
