Beyond the Lungs: Extrapulmonary Sarcoidosis
This infographic maps out how sarcoidosis can affect virtually every system in the body. Here’s a summary of the major topics covered:
Neurological :Cranial Nerve Palsy affects 5–15% of cases as part of neurosarcoidosis, with facial palsy (Cranial Nerve VII) being the most frequent finding.
Ocular:Ocular involvement occurs in 25–50% of cases. Anterior or posterior uveitis is the most common manifestation and can lead to vision loss if untreated.
Cardiac :Sarcoidosis can cause AV blocks or ventricular arrhythmias, and should be considered in young patients with unexplained heart block or syncope.
Hepatic & Splenic :Hepatosplenomegaly often presents asymptomatically, though elevated alkaline phosphatase may suggest a cholestatic pattern.
Renal: Beyond hypercalcemia-related issues, the kidneys can be affected by granulomatous interstitial nephritis and rarely proteinuria.
Metabolic:The hypercalcemia mechanism involves increased CYP27B1 activity in sarcoid macrophages, potentially causing renal stones and nephrocalcinosis.
Hematologic: Systemic sarcoidosis can present as anemia, leukopenia, or thrombocytopenia, often linked to hypersplenism.
Dermatologic: Erythema nodosum indicates a good prognosis, while lupus pernio (chronic skin lesions) signals a poorer long-term outlook.
Musculoskeletal: Bone cysts and arthritis include acute ankle arthritis, chronic arthropathy, and characteristic “lace-like” bone cysts in the phalanges.
Key Clinical Syndromes: Two notable syndromes are highlighted — Heerfordt Syndrome (uveitis, parotitis, facial palsy, and fever) and Löfgren Syndrome (erythema nodosum, bilateral hilar lymphadenopathy, and acute ankle arthritis).