Diagnosis and Detection of Sarcoidosis An Official American Thoracic Society Clinical Practice Guideline

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperReviewResearchpeer-review

  • Elliott D. Crouser, Division of Pulmonary, Critical Care and Sleep Medicine
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  • Lisa A. Maier, Division of Environmental and Occupational Health
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  • Robert P. Baughman, University of Cincinnati Medical Center
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  • Eric Abston, Boston University School of Medicine
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  • Richard C. Bernstein, Pennsylvania State University
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  • Ron Blankstein, Harvard Medical School
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  • Catherine A. Bonham, University of Virginia
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  • Edward S. Chen, Johns Hopkins Medical School
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  • Daniel A. Culver, Cleveland Clinic
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  • Wonder Drake, Vanderbilt University
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  • Marjolein Drent, St. Antonius Ziekenhuis, Maastricht University
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  • Alicia K. Gerke, University of Iowa
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  • Michael Ghobrial, Cleveland Clinic
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  • Praveen Govender, Boston University School of Medicine
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  • Nabeel Hamzeh, University of Iowa
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  • W. Ennis James, Medical University of South Carolina
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  • Marc A. Judson, Albany Medical College
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  • Liz Kellermeyer, National Jewish Health
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  • Shandra Knight, National Jewish Health
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  • Laura L. Koth, University of California at San Francisco
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  • Adam S. Morgenthau, Icahn School of Medicine at Mount Sinai
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  • Karen C. Patterson, University of Pennsylvania, Brighton and Sussex Medical School
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  • Venerino Poletti, Morgagni Hospital
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  • Subha V. Raman, Ohio State University, The Ohio State University
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  • Melissa H. Tukey, Kaiser Permanente
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  • Gloria E. Westney, Morehouse School of Medicine
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  • Kevin C. Wilson, Boston University School of Medicine

Background: The diagnosis of sarcoidosis is not standardized but is based on three major criteria: a compatible clinical presentation, finding nonnecrotizing granulomatous inflammation in one or more tissue samples, and the exclusion of alternative causes of granulomatous disease. There are no universally accepted measures to determine if each diagnostic criterion has been satisfied; therefore, the diagnosis of sarcoidosis is never fully secure. Methods: Systematic reviews and, when appropriate, meta-analyses were performed to summarize the best available evidence. The evidence was appraised using the Grading of Recommendations, Assessment, Development, and Evaluation approach and then discussed by a multidisciplinary panel. Recommendations for or against various diagnostic tests were formulated and graded after the expert panel weighed desirable and undesirable consequences, certainty of estimates, feasibility, and acceptability. Results: The clinical presentation, histopathology, and exclusion of alternative diagnoses were summarized. On the basis of the available evidence, the expert committee made 1 strong recommendation for baseline serum calcium testing, 13 conditional recommendations, and 1 best practice statement. All evidence was very low quality. Conclusions: The panel used systematic reviews of the evidence to inform clinical recommendations in favor of or against various diagnostic tests in patients with suspected or known sarcoidosis. The evidence and recommendations should be revisited as new evidence becomes available.

Original languageEnglish
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume201
Issue8
Pages (from-to)E26-E51
Number of pages26
ISSN1073-449X
DOIs
Publication statusPublished - Apr 2020

    Research areas

  • Cardiac sarcoidosis, Endobronchial ultrasound biopsy, Granuloma, Pulmonary hypertension, Rare lung disease

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ID: 191034612