In Europe, a higher onset of the disease has been recorded in the northern part (around 60 per 100,000) than in southern European countries, including Italy (<10 per 100,000). Sarcoidosis affects individuals of all ages irrespective of race or ethnicity, with maximum incidence among people aged 20–39 years, and quite more prevalent in women, non-smokers, and in rural communities. The prevalence and incidence of sarcoidosis are not well known worldwide owing to the challenges associated with ascertaining the number of asymptomatic patients. More than 100 articles were extensively reviewed for the purpose of this review. Bibliographies of all selected articles were reviewed, and we also included any relevant information from our personal files. To identify the studies included in this review, we performed an intensive search of the electronic databases, PubMed and MEDLINE, for relevant studies published between 1980 and the present using the following terms: sarcoidosis, pulmonary sarcoidosis, and extrapulmonary sarcoidosis. Many studies suggest that not only unknown antigens are responsible for this disease but also genetic susceptibility, environmental factors, and in some instances, this disease may be result from autoimmune activation. These activated cells discharge various mediators, including cytokines, chemokines, and reactive oxygen species that may be involved in the progression of sarcoidosis. The etiology of the disease is still unknown but some studies have reported that an unidentified antigen processed by activated macrophages instigates an immune response regulated by T-cells and macrophages. Sarcoidosis may present with a wide range of clinical assignations ranging from asymptomatic to fatal. The clinical presentation of sarcoidosis varies depending on the specific organ involved. Sarcoidosis occurs worldwide and has been reported in all racial and ethnic groups no race, sex, or age is immune to it. In addition to the lungs, the skin, liver, spleen, lymph nodes, upper respiratory tract, heart, and nervous system have all been shown to be affected by this disease and account for between 10 and 30 %. Previous data suggested that at least 90% of sarcoidosis patients have manifestations in the lungs. Unidentified etiology and the multisystemic nature of the disease have made it more complex. ĭespite its long history, this disease remains enigmatic. In India, the first case of sarcoid was published in the Journal of the School of Tropical Medicine, Calcutta in 1956, while in 1923 the first case of Familial sarcoidosis was recorded in two affected sisters. Later, Caesar Boeck used the term sarkoid (sarcoid) for the first time when he assumed that these lesions were similar to sarcoma, but benign. In 1889, Ernest Besnier described the cutaneous hallmarks of chronic sarcoidosis as lupus pernio. The first case of sarcoidosis was reported in 1877 by Jonathan Hutchinson at the King’s College Hospital in London (United Kingdom). Sarcoidosis is a systemic multisystem inflammatory disorder of unknown etiology characterized by the presence of non-caseating granulomas. This review discusses the causes and clinical features of sarcoidosis, and the improvements made in its prognosis, therapeutic management, and the recent discovery of potential biomarkers associated with the diagnostic assay used for sarcoidosis confirmation. Due to its unknown etiology, early diagnosis and detection are difficult however, the advent of advanced technologies, such as endobronchial ultrasound-guided biopsy, high-resolution computed tomography, magnetic resonance imaging, and 18F-fluorodeoxyglucose positron emission tomography has improved our ability to reliably diagnose this condition and accurately forecast its prognosis. Exposures to insecticides, herbicides, bioaerosols, and agricultural employment are also associated with an increased risk for sarcoidosis. Various factors, including infection, genetic predisposition, and environmental factors, are involved in the pathology of sarcoidosis. Diagnosis can be difficult because of nonspecific symptoms and can only be verified following histopathological examination. Sarcoidosis is not influenced by sex or age, although it is more common in adults (< 50 years) of African-American or Scandinavians decent. Sarcoidosis usually presents with persistent dry cough, eye and skin manifestations, weight loss, fatigue, night sweats, and erythema nodosum. Sarcoidosis is a multisystem granulomatous disease with nonspecific clinical manifestations that commonly affects the pulmonary system and other organs including the eyes, skin, liver, spleen, and lymph nodes.
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