> consider sarcoidosis in young, healthy patient with multiple [[Cavitary lung lesion|cavitating lung lesions]] who has erythema nodosum - multi-system granulomatous disease of unknown cause - most common sites: lungs and intra-thoracic lymph nodes - 10-20x increase in african americans, especially females - onset usually <40 years - autosomal recessive inheritance - associated with erythema nodosum, polyarthritis, *bilateral hilar lymphadenopathy* - usually starts minimal symptoms (cough, chest discomfort, normal lugn fields) **Path**: - non-caseating granulomas **extra-pulmonary manifestations:** - [[lymphadenopathy]] ; usually asymptomatic and incidental - skin: curaneous granulomas, erythema nodosum - hepatosplenomegaly - [[hypercalcaemia]] - due to hypersensitivity to vitamin D; 5-10% of cases, usually resolves with steroids - cardiac - ventricular arrhythmias, heart failure, sudden cardiac death **management** - asymptomatic not much - more symptoms → pred 30-60 mg/day - skin involvement → chloroquine - eyes → topical glucocorticoids