Sarcoidosis A018

Current RMA Instruments

Changes from previous Instruments

ICD Coding

• ICD-10-AM Code: D86

Brief description

Sarcoidosis is a chronic multisystem disorder characterised by the formation of non-caseating granulomas (small lumps or clusters of immune cells) that disrupt the normal structure of affected tissues. It most commonly involves the lungs, which are affected in about 90% of cases, but can also involve the skin, eyes, lymph nodes, liver, heart and nervous system. In the lungs, granulomas may cause airway narrowing, inflammation, and scarring (fibrosis) of lung tissue. 

Confirming the diagnosis

Diagnosis confirmation typically requires a combination of clinical symptoms and signs consistent with sarcoidosis, imaging (chest X-ray or CT scan) and histological evidence (biopsy specimens of affected tissues). In addition, the diagnostic process often involves tests to rule out other conditions (e.g. tuberculosis, fungal diseases, malignancies and other autoimmune conditions)

To establish the diagnosis, the assessment and/or management often involves consultation with general physicians, respiratory physicians as well as other specialist doctors such as dermatologists, ophthalmologists, rheumatologists. This is a condition that can involve multiple areas of the body. 

Additional diagnoses covered by SOP

• Besnier-Boeck-Schaumann disease
• Boeck's sarcoid or Lupus Pernio (where skin is involved)

Conditions not covered by SOP

• Granulomas caused by fungal infections #
• Tuberculosis *

* another SoP applies- the SOP has the same name unless otherwise specified

# non- SoP condition

Clinical onset

Sarcoidosis is frequently detected incidentally on imaging, most often as bilateral hilar lymphadenopathy on chest x-ray or CT scan. When present, symptoms are usually non-specific and may include cough, dyspnoea, chest pain, fatigue, malaise, low grade fever, and weight loss. Less commonly, patients may present with other features such as skin lesions (e.g. erythema nodosum), eye symptoms (e.g. uveitis), or painful joints (arthralgia). the clinical onset is typically defined as the time of diagnosis or the point at which imaging abnormalities- later confirmed as sarcoidosis- were first identified. In some cases, the onset may be backdated based on a consistent symptom history. 

Clinical worsening

Sarcoidosis is most commonly a relatively mild disease that either resolves spontaneously or remains stable without significant progression. However, in a subset of patients, it can become chronic, progressively involve multiple organ systems and in rare cases, lead to life-threatening complications.