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Sarcoidosis A018

Document
Last amended 
11 July 2016
Current RMA Instruments:
Reasonable Hypothesis SOP
59 of 2016
Balance of Probabilities SOP
60 of 2016
Changes from previous Instruments:

SOP Bulletin 191

ICD Coding:
  • ICD-9-CM Codes: 135
  • ICD-10-AM Codes: D86
Brief description

Sarcoidosis is a multisystem disorder that causes nodules (granulomas) of inflamed tissue to develop in the body's organs. The lungs are affected in approximately 90 percent of patients. Other tissues commonly involved include the skin, eyes, and lymph nodes.  Granulomas in the lungs can cause narrowing of the airways and inflammation and scarring (fibrosis) of lung tissue.

Confirming the diagnosis

The diagnosis is based upon multiple factors, including signs and symptoms, abnormalities on chest X-ray (or CT scan), and microscopic examination of one or more biopsy specimens from involved tissues or organs. In addition, the diagnostic process often involves tests to rule out other conditions, including tuberculosis.

The relevant medical specialist is a general physician or respiratory physician. Multiple different specialists may be involved in patient care.

Additional diagnoses covered by SOP
  • Besnier-Boeck-Schaumann disease
  • Boeck's sarcoid
Clinical onset

The disease is often detected incidentally by radiographic abnormalities.  Common presenting symptoms are generally non-specific and include cough, dyspnea, and chest pain accompanied by fatigue, malaise, fever, and weight loss.  Clinical onset will generally be at the the time of confirmation of diagnosis or when radiographic abnormalities, subsequently confirmed to be due to sarcoidosis, were first detected. It may be possible to back date onset based on presenting symptoms.

Clinical worsening

Sarcoidosis is most commonly a relatively mild disease that resolves on its own or does not progress. In some patients, sarcoidosis may progress over many years and involve many organs and be life threatening.