Pulmonary sarcoidosis Predictors of relapse: Are we there yet?
Humankind has walked on the moon, is set to land on Mars in the near future, but sadly, has not solved the enigma of sarcoidosis. This disease, sarcoidosis, has baffled clinicians, researchers, and scientists alike. Heterogeneous clinical presentations, unclear pathophysiology, and inability to pinpoint etiologic agent have halted progress in its therapeutics and research. So much so that there is a paucity of clear cut classification or diagnostic criteria for sarcoidosis. The American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and Other Granulomatous[1] statement on sarcoidosis was published in 1999. It suggests that "when clinico radiological findings are supported by histologic evidence of noncaseating epithelioid cell granulomas," the diagnosis of sarcoidosis can be entertained. However, the clinicoradiological findings are not clearly described. Subsequently, Heinle and Chang[2] have proposed a diagnostic criterion based on a combination of clinical, radiographic, and histological features alongside the elimination of disorders with similar clinical features. Bickett et al.[3] have tried to quantitate the clinical features consistent with biopsy proven sarcoidosis to enhance diagnostic certainty.