Parminder Singh1 , Vandana Midha2 , Rajeev Gupta3
BACKGROUND Sarcoidosis is a multisystem disorder of unknown aetiology and an under reported disease in India. The reason is the similarity to tuberculosis and lack of facilities to perform invasive tests compounded by lack of awareness among physicians and pathologists. Diagnosis is established on the basis of clinicoradiological features supported by histopathological evidence of non-caseating granulomas. We wanted to determine the clinical, laboratory and imaging profile of sarcoidosis patients. METHODS This study included 54 patients [new (17) and old (37) cases] of sarcoidosis who presented in the Department of Medicine and Chest & TB, Dayanand Medical College and Hospital, Ludhiana, over a period of one and half years. RESULTS Males comprised 51.85% of the patients. Before coming to our clinic, 14.81% patients had been misdiagnosed to have TB. Predominant symptoms were cough (n=34, 62.96%) and fever (n=22, 44.74%) followed by breathlessness (n= 15, 27.78%), chest pain (n=5, 9.26). Pulmonary function testing showed restriction with impaired diffusion in 80% patients. The most common radiological feature was bilaterally symmetrical hilar lymphadenopathy (stage I disease). Transbronchial lung biopsy (TBLB) had a very high diagnostic yield (60.87%). CONCLUSIONS Sarcoidosis has clinical, laboratory and radiological manifestations which vary worldwide according to race. In developing country with high prevalence of TB like India, sarcoidosis is often misdiagnosed as TB. Hence, patients having hilar lymphadenopathy with or without pulmonary infiltrates should be investigated for sarcoidosis.
