What is your approach to management of a patient with sarcoidosis who is asymptomatic, but demonstrates progressively enlarging mediastinal lymphadenopathy and rising soluble IL-2 receptor levels?

My concern here would be whether such a patient does not have 'asymptomatic sarcoidosis' but has CVID (often associated with multifocal non-caseating granulomas) with an associated B-cell lymphoma (for which such patients have a 30-fold Relative Risk) with developing mHLH (elevated sIL-2 being an as...

There are no diagnostic or prognostic biomarkers specific for sarcoidosis, and proposed surrogate markers for tracking disease activity, including soluble IL-2, serum angiotensin-converting enzyme (ACE), and even the presence of fluorodeoxyglucose (FDG)-avid lesions, have limited predictive value.

F...

Let’s assume that other causes of T-cell activation have been excluded, such as lymphoma, infection, and autoimmune disease, and that we are confident in our diagnosis of sarcoidosis. We do not know the cause of sarcoidosis, and it is possible that the granulomatous response is “a good thing.” Many ...

Sarcoidosis treatment is generally reserved for patients with symptomatic disease that impairs quality of life or those at risk of irreversible organ damage. Although enlarging mediastinal lymphadenopathy and rising soluble interleukin-2 receptor (sIL-2R) levels suggest increased immune activity, ne...