How would you treat a sarcoid patient whose only manifestations are B symptoms and generalized lymphadenopathy?

Historically, the term “B symptoms” was developed to describe poor prognostic signs and symptoms in stratifying patients with lymphoma. Specifically, these were fever, drenching night sweats, and significant weight loss (>10% over six months) and portended worse prognosis. B symptoms, of course, can be present in many other neoplastic, infectious, and immunologic disorders, and reflect a generalized inflammatory state. However, over time, other non-specific constitutional manifestations such as chronic fatigue became included under the umbrella of “B symptoms”.

Sarcoid patients can have genuine B symptoms, but the most important initial step is to not assume from the outset that they are due to the underlying sarcoidosis. The possibility of ...