title: Life-threatening situations in sarcoidosis.
abstract: Life-threatening situations in sarcoidosis are extremely rare. They may be due to failure of vital organs--lungs, heart, kidney, liver and brain--and usually due to irreversible fibrosis. Respiratory failure follows irreversible pulmonary fibrosis and the development of cor pulmonale. Cardiac sarcoidosis is more sinister for it may be silent, ill-recognised with sudden death or high morbidity. It needs sophisticated techniques to uncover this latent iceberg. Renal failure may be due to granulomatous interstitial nephritis and/or nephrocalcinosis. Hepatic failure is due to intrahepatic cholestasis, portal hypertension and bleeding oesophageal varices. Neurosarcoidosis carries a mortality of 10 per cent, over twice that of sarcoidosis overall. The treatment of each situation is discussed including organ transplantation.
authors.affiliation: Royal Free Hospital, London, U.K.
authors.forename: D G
authors.initials: DG
authors.lastname: James
mesh_terms: D000328:Adult; D016207:Cytokines / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006333:Heart Failure / Q000209:etiology* / Q000628:therapy; D006801:Humans; D017093:Liver Failure / Q000209:etiology* / Q000628:therapy; D008875:Middle Aged; D016377:Organ Transplantation; D051437:Renal Insufficiency / Q000209:etiology* / Q000628:therapy; D012131:Respiratory Insufficiency / Q000209:etiology* / Q000628:therapy; D012507:Sarcoidosis / Q000150:complications* / Q000276:immunology / Q000628:therapy; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: D016207:Cytokines; D005938:Glucocorticoids