title: Approaches to the treatment of some of the troublesome manifestations of sarcoidosis.
abstract: Sarcoidosis can be a major therapeutic challenge given its multiplicity of clinical presentations, variable combination of organ involvement and severity, and unpredictable longitudinal behaviour. Six manifestations of sarcoidosis are especially difficult to manage because of (i) an incomplete knowledge of causation - fatigue and small fibre neuropathy, (ii) the rare occurrence in sarcoidosis - intra-abdominal complications or (iii) the potentially life-threatening consequences in some patients - neurological disease, pulmonary hypertension and hypercalcaemia. In none of these situations have a prospective, double-blind, placebo-controlled trial of any therapy been conducted. Despite this absence of any firm evidence base to support therapeutic recommendations, these six entities can be extremely problematic for the practising clinician. It is for this reason that we have focused in this review on these six disease manifestations and provided a synopsis of each problem together with suggested treatment approaches, based on an analysis of the current literature.
authors.affiliation: Department of Medicine, Karolinska University Hospital, Karolinska Institutet and Centre for Molecular Medicine, Stockholm, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Eklund
authors.forename: R M
authors.initials: RM
authors.lastname: du Bois
mesh_terms: D015746:Abdominal Pain / Q000209:etiology / Q000628:therapy; D019317:Evidence-Based Medicine; D005221:Fatigue / Q000209:etiology / Q000628:therapy; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology / Q000628:therapy; D007415:Intestinal Obstruction / Q000209:etiology / Q000628:therapy; D009325:Nausea / Q000209:etiology / Q000628:therapy; D009422:Nervous System Diseases / Q000209:etiology / Q000628:therapy; D010523:Peripheral Nervous System Diseases / Q000209:etiology / Q000628:therapy; D011504:Protein-Losing Enteropathies / Q000209:etiology / Q000628:therapy; D012507:Sarcoidosis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology / Q000628:therapy; D015431:Weight Loss
keywords: less common manifestations; management; sarcoidosis; treatment