How do you approach a patient with sarcoidosis who cannot tolerate steroids and who is developing ILD?   

As with most questions about sarcoidosis, clear understanding of the relevant clinical context should first be established. While interstitial lung disease (ILD) is a common manifestation of sarcoidosis, it often can be safely monitored without treatment, and so radiologically identified sarcoid ILD...

I agree with Dr. @Yee’s comments and approach. However, I submit that all persons with proven pulmonary sarcoidosis have an interstitial component, regardless of stage or disease severity. Bronchoalveolar lavage in stage I cases with normal-appearing lung parenchyma and lung function demonstra...

I will preface by saying that I'm not a specialty expert like Dr. Yee and Dr. Perez above. However, if you are seeing such a patient for a new diagnosis of pulmonary sarcoidosis AND have decided that they warrant treatment, one could also consider methotrexate (MTX) as a first-agent! Its non-inf...