Immunosuppressive and cytotoxic therapy for pulmonary sarcoidosis

Sarcoidosis is a common, multi system, granulomatous disorder with frequent lung involvement that can in some cases progress to pulmonary fibrosis. The severity of the lung involvement is assessed on the basis of the patient’s symptoms (particularly dyspnoea and cough), changes on the chest x-ray (CXR) and on deteriorating lung function. High resolution CT scans are now important in differentiating sarcoid from other interstitial lung diseases. Patientsmay also complain of systemic symptoms such as lethargy. Involvement of other organs including liver, skin and brain is also common in this group of patients. Oral corticosteroids are often prescribed first in such cases. Immunosuppressives and cytotoxic agents are also prescribed for those who do not respond to steroids and show a progressive deterioration or to those who are unable to tolerate steroids (steroid sparing agents)