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Editorials |

Of Time and Experience : Sarcoidosis Revisited

Albert Miller, MD, FCCP
Author and Funding Information

Affiliations: Jamaica, NY 
 ,  Dr. Miller is Director, Pulmonary Medicine, Saint Vincent Catholic Medical Centers, Brooklyn Queens Region.

Correspondence to: Albert Miller, MD, FCCP, Director, Pulmonary Medicine, Saint Vincent Catholic Medical Centers, Brooklyn Queens Region, Suite 3-J, 88–25 153rd St, Jamiaca, NY 11432-3748; e-mail: amiller@cmcny.com



Chest. 2002;121(1):3-5. doi:10.1378/chest.121.1.3
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Extract

Sarcoidosis, an immunopathogenic inflammatory disease of unproven etiology and universal organ involvement, has generated a vast literature. We have a good understanding of its clinical and laboratory manifestations, and a consensus exists that symptomatic and/or significantly organ-impairing disease can be treated. Certain questions continue to be addressed, however, in much of the literature, with no clearer answers today than existed 25 years ago, as a recent revisit of the proceedings of an early international symposium on sarcoidosis held in New York in 1975 made eerily apparent: Are there acceptable substitutes for systemic corticosteroids? Are they useful early in therapy, or only when steroids have proven ineffectual or cannot be discontinued without relapse, or have caused morbidity? How can the course and outcome of a particular patient be predicted? What is the optimum dose and duration of therapy? Unquestionable advances in imaging and in understanding and measurement of immune and inflammatory processes have not answered these questions.


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sarcoidosis

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