Sarcoidosis: federal clinical guidelines for diagnosis and treatment

Abstract

Sarcoidosis is a multi-organ granulomatosis of unknown origin. Modern diagnostic methods allow detecting this disease at an early stage. The absence of specific markers requires a comprehensive approach to diagnosis based on comparison of radiation, clinical, morphological and functional data. The course of sarcoidosis without damage to the respiratory system presents significant difficulties. It is extremely important to understand the time and means of starting Sarcoidosis’s treatment to avoid the early initiation of hormones and cytostatics and, on the other hand, to timely respond to progression and threatening conditions. Methods. Clinical recommendations are based on the analysis of Russian and English publications of the latest sarcoidosis research. The target audience of these clinical guidelines are therapists, general practitioners, pulmonologists, TB doctors, rheumatologists, dermatologists, radiation diagnosticians, immunologists, and clinical pharmacologists. Each thesis-recommendation for diagnosis and treatment is evaluated on an 1 to 5 scale of levels of evidence and an A, B, C scale of the grades of recommendations. The clinical guidelines also contain comments and explanations for the theses-recommendations, diagnostic algorithms, treatment strategies, reference materials on the use of recommended drugs. Conclusion. Current information on epidemiology, clinical manifestations, diagnosis and management strategies for patients with sarcoidosis are covered in the presented clinical guidelines. Approved by the decision of the Scientific and Practical Council of the Ministry of Health of the Russian Federation (2022).

The Promising Role of Oncomarkers CA 19-9 and CA 125 in the Diagnosis of Progressive Pulmonary Fibrosis

“…У всех пациентов диагноз ИЗЛ установлен на основании анамнестических, клинико-лабораторных, функциональных и компьютерно-томографических данных путем мультидисциплинарного обсуждения, руководствуясь отечественными и международными руководствами и рекомендациями (клинические рекомендации «Идиопатический легочный фиброз» (2021), «Саркоидоз» (2019); ERS Clinical Practice Guidelines on Treatment of Sarcoidosis (2021), Diagnosis of Idiopathic Pulmonary Fibrosis. An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline (2018); Diagnosis and Management of Connective Tissue Disease-Associated Interstitial Lung Disease in Australia and New Zealand: A Position Statement from the Thoracic Society of Australia and New Zealand (2020); Diagnosis of Hypersensitivity Pneumonitis in Adults: An Official ATS/JRS/ALAT Clinical Practice Guideline (2020))[2,[16][17][18][19][20]. Всем пациентам выполнялась компьютерная томография (КТ) органов грудной клетки на аппарате Somatom Emotion 16 фирмы Siemens (Германия).…”