Sarcoidosis: Unknown Etiology and Genetic Predisposition Provides Therapeutic Challenges

Abstract

Sarcoidosis is an idiopathic multisystem disorder characterized by noncaseating epithelioid granulomas predominately affecting lungs and lymph nodes, but with potential to affect any organ system. Sarcoidosis shares similarities in development to other infectious granulomatous diseases, such as berylliosis and tuberculosis; however, its elusive etiology and non-distinctive histology have provided many diagnostic challenges. Evidence of a transferrable antigen combined with a high incidence rate in the lungs has focused efforts primarily on antigens with airborne transmissibility. While Mycobacterium tuberculosis and Propionibacterium acnes have provided strong associations to implicate each as a contributor to sarcoidosis pathogenesis, detection challenges remain and consensus of a definitive antigen is lacking.

Introductory Chapter: Orofacial Sarcoidosis and Noncaseating Granulomatosis

“…Sarcoidosis is a multisystem disorder that may affect any organ system such as the lungs, lymph nodes, skin, eyes, liver, heart, and nervous, musculoskeletal, renal, and endocrine systems [52]. The lungs are the site of involvement and granuloma formation [52]; 90% of patients have clinical manifestation of sarcoidosis in the lungs [53]. Oral involvement has been considered as the first feature of the disease although intraoral presentations of sarcoidosis and also tongue sarcoidosis are particularly rare and uncommon [54].…”