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Total 5961 results found since Jan 2013.

18F-FDG PET/CT in pulmonary sarcoidosis: quantifying inflammation by the TLG index.
Conclusion:18F-FDG PET/CT improved imaging and detection of pulmonary involvement and through TLG value revealed the deleterious smoking effect. The fact that TLG neither detected patients with clinical symptoms and functional impairment nor identified those requiring treatment once again confirms that in pulmonary sarcoidosis the link between activity, severity and decision to treat still eludes us. PMID: 31626563 [PubMed - as supplied by publisher]
Source: Expert Review of Respiratory Medicine - October 20, 2019 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

18F-FDG PET/CT of Multiorgan Sarcoid-Like Reaction During Anti–PD-1 Treatment for Melanoma
We report a case of a 50-year-old woman treated with anti–PD-1 inhibition for metastatic melanoma. During treatment, extensive and transient histopathologically confirmed sarcoid-like reaction was detected in multiple organ systems and at different time points using 18F-FDG PET/CT imaging. Immune-related adverse events during anti-PD-1/PD-L1 antibody treatment are increasingly being reported. This case report emphasizes the broad spectrum of possible presentations of sarcoid-like reaction detected by 18F-FDG PET/CT and its evolution in time. For the clinician, awareness of these immune-related adverse events helps to acc...
Source: Clinical Nuclear Medicine - October 18, 2019 Category: Nuclear Medicine Tags: Interesting Images Source Type: research

Dual Time-Point 18F-FDG PET/CT in Spinal Sarcoidosis: A Single Institution Case Series
Conclusion. 18F-FDG PET/CT imaging is a noninvasive imaging technique that can be crucial in the diagnosis of sarcoidosis of the spinal cord and help avoid unnecessary procedures. Level of Evidence: 4
Source: Spine - October 17, 2019 Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research

Atypical sarcoid-like granulomatous reactions in lymphoma: natural history and impact on management
Publication date: Available online 16 October 2019Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): R. Ramanan, T. Fancourt, S. Berlangieri, A. Grigg
Source: Clinical Lymphoma Myeloma and Leukemia - October 17, 2019 Category: Cancer & Oncology Source Type: research

Tattoo hypersensitivity reaction in a patient receiving combined BRAF and MEK inhibitors.
We report a similar new case strongly suggesting a specific effect of this drug combination. PATIENTS AND METHODS: A 58-year-old man bearing 20-year-old tattoos was treated with dabrafenib and trametinib for advanced melanoma. A painful erythematous swelling appeared on all the patient's tattoos two months later, while his general tolerance of the treatment was poor. Skin biopsy demonstrated perivascular lympho-histiocytic infiltrate without granuloma, but with prominent pigment-loaded macrophages. Inflammatory signs quickly regressed after drug discontinuation. DISCUSSION: Great similarity exists between this ne...
Source: Annales de Dermatologie et de Cenereologie - October 15, 2019 Category: Dermatology Authors: Rohmer E, Scrivener JN, Schissler C, Cribier B, Lenormand C Tags: Ann Dermatol Venereol Source Type: research

Mayo Clinic Q and A: What is sarcoidosis?
DEAR MAYO CLINIC: I recently was diagnosed with sarcoidosis, but I don't currently have symptoms. What causes sarcoidosis? Could it go away on its own? What should I be on the lookout for as far as symptoms that may develop? ANSWER: Sarcoidosis is an inflammatory disease characterized by the formation of tiny collections of inflammatory [...]
Source: News from Mayo Clinic - October 15, 2019 Category: Databases & Libraries Source Type: news

Posaconazole in vitro action on peripheral blood mononuclear cells from sarcoidosis patients
Conference abstracts
Source: The Aspergillus Website - updates - October 13, 2019 Category: Respiratory Medicine Authors: MeganB Source Type: news

Neck as mediastinal extension: diagnosis of sarcoidosis by core biopsy of cervical lymph nodes
ConclusionsGiven the clear advantages of cervical diagnosis in terms of invasiveness and economy compared to mediastinal alternatives, it is suggested that where the expertise for core biopsy of normal sized cervical lymph nodes is readily available, the technique may be considered as a first line investigation for the diagnosis of sarcoidosis.
Source: The Clinical Respiratory Journal - October 12, 2019 Category: Respiratory Medicine Authors: Ahmed Fahim, MM Qasim, David Rosewarne Tags: ORIGINAL ARTICLE Source Type: research

Sarcoidosis presenting with and without Löfgren’s syndrome: clinical, radiological and behavioral differences observed in a group of 691 patients
Conclusions: Löfgren’s syndrome is a well-differentiated form of sarcoidosis with persuasive different epidemiological, clinical, radiological and prognostic features.
Source: Joint Bone Spine - October 11, 2019 Category: Orthopaedics Source Type: research

The rate of myocardial perfusion recovery after steroid therapy and its implication for cardiac events in cardiac sarcoidosis and primarily preserved left ventricular ejection fraction
ConclusionsMyocardial perfusion was recovered by steroid therapy in 61% and preserved in 8% of patients. Myocardial perfusion recovery after steroid therapy was significantly associated with a low incidence of MACE.
Source: Journal of Nuclear Cardiology - October 11, 2019 Category: Nuclear Medicine Source Type: research

Pulmonary complications of immune checkpoint inhibitors in patients with nonsmall cell lung cancer
Immune checkpoint inhibitor-related pneumonitis (ICI-P) during cancer treatment is rarely observed (<5%). ICI-P is more often observed in patients with nonsmall cell lung cancer (NSCLC) than in those with other cancers. Likewise, it is more common in those receiving programmed cell death (PD)-1/PD-1 ligand inhibitors rather than cytotoxic T-lymphocyte antigen (CTLA)-4 inhibitors alone. The frequency of ICI-P is higher when anti-PD-1 and anti-CTLA-4 are administered concomitantly. Despite the low fatality rate (13%), ICI-P is the leading cause of ICI-related deaths. This narrative review focuses on the epidemiology, clin...
Source: European Respiratory Review - October 9, 2019 Category: Respiratory Medicine Authors: Cadranel, J., Canellas, A., Matton, L., Darrason, M., Parrot, A., Naccache, J.-M., Lavole, A., Ruppert, A.-M., Fallet, V. Tags: Lung cancer Reviews Source Type: research

IJERPH, Vol. 16, Pages 3798: Neighborhood Deprivation and Risks of Autoimmune Disorders: A National Cohort Study in Sweden
Conclusion: This study is the largest to date analyzing the potential influence of neighborhood deprivation on ADs. Our results indicate that neighborhood deprivation may affect risk of ADs, independent of individual level sociodemographic characteristics. For health care policies, both individual and neighborhood level approaches seem to be of importance.
Source: International Journal of Environmental Research and Public Health - October 9, 2019 Category: Environmental Health Authors: Xinjun Li Jan Sundquist Tsuyoshi Hamano Kristina Sundquist Tags: Article Source Type: research

JCS 2016 Guideline on Diagnosis and Treatment of Cardiac Sarcoidosis  - Digest Version.
JCS 2016 Guideline on Diagnosis and Treatment of Cardiac Sarcoidosis - Digest Version. Circ J. 2019 Oct 09;: Authors: Terasaki F, Azuma A, Anzai T, Ishizaka N, Ishida Y, Isobe M, Inomata T, Ishibashi-Ueda H, Eishi Y, Kitakaze M, Kusano K, Sakata Y, Shijubo N, Tsuchida A, Tsutsui H, Nakajima T, Nakatani S, Horii T, Yazaki Y, Yamaguchi E, Yamaguchi T, Ide T, Okamura H, Kato Y, Goya M, Sakakibara M, Soejima K, Nagai T, Nakamura H, Noda T, Hasegawa T, Morita H, Ohe T, Kihara Y, Saito Y, Sugiyama Y, Morimoto SI, Yamashina A, Japanese Circulation Society Joint Working Group PMID: 31597819 [PubMed - as supplied by publisher]
Source: Circulation Journal - October 9, 2019 Category: Cardiology Authors: Terasaki F, Azuma A, Anzai T, Ishizaka N, Ishida Y, Isobe M, Inomata T, Ishibashi-Ueda H, Eishi Y, Kitakaze M, Kusano K, Sakata Y, Shijubo N, Tsuchida A, Tsutsui H, Nakajima T, Nakatani S, Horii T, Yazaki Y, Yamaguchi E, Yamaguchi T, Ide T, Okamura H, Kat Tags: Circ J Source Type: research

Improved Diagnostic Yield and Specimen Quality with EBUS-Guided Forceps Biopsies: A Retrospective Analysis
ConclusionsWe suggest that relative to SOC, ca-TBFB improves diagnostic yield for sarcoidosis and lymphoma while providing uniformly better tissue quality and cellularity. We propose a protocol for use of this innovative technique.
Source: The Annals of Thoracic Surgery - October 5, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Improved Diagnostic Yield and Specimen Quality with EBUS-Guided Forceps Biopsies: A Retrospective Analysis.
CONCLUSIONS: We suggest that relative to SOC, ca-TBFB improves diagnostic yield for sarcoidosis and lymphoma while providing uniformly better tissue quality and cellularity. We propose a protocol for use of this innovative technique. PMID: 31593653 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - October 5, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Ray AS, Li C, Murphy TE, Cai G, Araujo KL, Bramley K, DeBiasi EM, Pisani MA, Cortopassi IO, Puchalski JT Tags: Ann Thorac Surg Source Type: research

The effect of cigarette smoking on bronchoalveolar lavage protein profiles from patients with different interstitial lung diseases.
CONCLUSIONS: Smoking exposure leads to a significant dysregulation of a large number of molecular pathways involved in interstitial lung diseases and the proteomic studies applied to the study of BAL of idiopathic pulmonary fibrosis, sarcoidosis and other ILD contributed to clarify the underlying pathogenetic mechanisms facilitating ILD development and biomarker discovery. PMID: 31577091 [PubMed - as supplied by publisher]
Source: Panminerva Medica - October 4, 2019 Category: General Medicine Tags: Panminerva Med Source Type: research

Metabolic Programming of Macrophages: Implications in the Pathogenesis of Granulomatous Disease
Metabolic reprogramming is rapidly gaining appreciation in the etiology of immune cell dysfunction in a variety of diseases. Tuberculosis, schistosomiasis, and sarcoidosis represent an important class of diseases characterized by the formation of granulomas, where macrophages are causatively implicated in disease pathogenesis. Recent studies support the incidence of macrophage metabolic reprogramming in granulomas of both infectious and non-infectious origin. These publications identify the mechanistic target of rapamycin (mTOR), as well as the major regulators of lipid metabolism and cellular energy balance, peroxisome pr...
Source: Frontiers in Immunology - October 4, 2019 Category: Allergy & Immunology Source Type: research

Genes and metabolic pathway of sarcoidosis: identification of key players and risk modifiers.
Conclusions: These results suggest that patients with vitamin D deficiency should be regularly tested for genetic modifiers that are related to sarcoidosis in order to prevent development of serious forms of sarcoidosis. PMID: 31572458 [PubMed]
Source: Archives of Medical Science - October 2, 2019 Category: General Medicine Tags: Arch Med Sci Source Type: research

Variability of Sarcoid Skin Manifestations Is Illustrated in a Patient With Multiple Concurrent Pinna Lesions.
PMID: 31578109 [PubMed - as supplied by publisher]
Source: Ear, Nose and Throat Journal - October 2, 2019 Category: ENT & OMF Authors: Jones SE, Pollak N Tags: Ear Nose Throat J Source Type: research

Effect of Fermented Oyster Extract on Musculoskeletal Biomarkers in Relative Sarcopenia Adults
Condition:   Muscular Sarcoidosis Interventions:   Dietary Supplement: Fermented oyster extract;   Dietary Supplement: Placebo Sponsor:   Pusan National University Yangsan Hospital Recruiting
Source: ClinicalTrials.gov - October 1, 2019 Category: Research Source Type: clinical trials

Drug-Induced Sweet Syndrome in a Man With Sarcoidosis: Are There Any Common Mechanisms of Pathogenesis?
No abstract available
Source: JCR: Journal of Clinical Rheumatology - October 1, 2019 Category: Rheumatology Tags: Letters to the Editor Source Type: research

1301PDeep learning radiomics distinguishes intrapulmonary disease from metastases in immunotherapy-treated melanoma patients
ConclusionsDeep learning can help to discriminate between intrapulmonary granulomatous disease, indeterminate calcified granulomas and intrapulmonary lymph nodes in anti-PD-1 treated melanoma patients. Further model development is needed to overcome the imbalanced “real clinical scenario” data to classify granulomatous disease in melanoma patients treated with anti-PD-1 immune checkpoint inhibitor blockade for implementation in the clinical workflow.Legal entity responsible for the studyThe authors.FundingHas not received any funding.DisclosureAll authors have declared no conflicts of interest.
Source: Annals of Oncology - October 1, 2019 Category: Cancer & Oncology Source Type: research

Multiple excisions of an equine sarcoid and the repercussions.
Abstract A 13-year-old Morgan crossbred mare was presented in May 2018 with a 10-cm mass on the medial aspect of the left hind fetlock. In September and November 2018 and June 2019 the mass was incompletely excised and continued to grow. A diagnosis of spindle cell tumor, consistent with equine sarcoid, was made based on histopathology from the last excision. PMID: 31597999 [PubMed - in process]
Source: The Canadian Veterinary Journal - October 1, 2019 Category: Veterinary Research Authors: Melinyshyn H Tags: Can Vet J Source Type: research

Pulmonary cryptococcosis: report of the first confirmed autochthonous case in Nepal.
We report a case of cryptococcal pneumonia in a 53 years old female Nepali patient with uncontrolled diabetes mellitus type 2 who empirically received multiple broad-spectrum antibiotics and standard anti-tubercular treatment as well as glucocorticosteroids for suspected sarcoidosis before the diagnosis was finally established. To our knowledge, this is the first confirmed autochthonous case of cryptococcosis reported from Nepal. PMID: 31580849 [PubMed - as supplied by publisher]
Source: Acta Tropica - September 30, 2019 Category: Infectious Diseases Authors: Sah R, Jaiswal A, Singla S, Prakash AK, Mittal SK, Aggarwal A, Singh S, Neupane S, Sah S, Sah R, Neumayr A Tags: Acta Trop Source Type: research

Retrospective Study on the Association of Biomarkers With Real-world Outcomes of Omalizumab-treated Patients With Allergic Asthma.
This study assessed omalizumab outcomes in real-world patients with allergic asthma stratified by pretreatment biomarker levels. METHODS: Patients with allergic asthma aged ≥12 years initiated on omalizumab with ≥12 months of data after index were identified in the Allergy Partners electronic medical records (2007-2018). Patients with ≥1 diagnosis of chronic obstructive pulmonary disease in combination with ≥10 pack-years of smoking, cystic fibrosis, Alpha-1 antitrypsin deficiency, bronchiectasis, interstitial lung disease, and sarcoidosis in the 12 months before or after index were excluded. Patients were str...
Source: Clinical Therapeutics - September 25, 2019 Category: Drugs & Pharmacology Authors: Kavati A, Zhdanava M, Ortiz B, Lecocq J, Schiffman B, Pilon D, Ho H, Lefebvre P, Stone B Tags: Clin Ther Source Type: research

Uveitis and deficient lens capsules: Effect of glued intraocular lens on the visual outcome and the reactivation of inflammation
Conclusion: Glued IOL can cause inflammation in uveitis eyes which can be managed medically with minimal complications.
Source: Indian Journal of Ophthalmology - September 23, 2019 Category: Opthalmology Authors: Dhivya Ashok Kumar Amar Agarwal Wasim Raja Kader Ali Source Type: research

Systemic sarcoidosis presenting as optic nerve head granuloma
Srikanta Kumar Padhy, Vinod KumarIndian Journal of Ophthalmology 2019 67(10):1714-1715
Source: Indian Journal of Ophthalmology - September 23, 2019 Category: Opthalmology Authors: Srikanta Kumar Padhy Vinod Kumar Source Type: research

Comment on: Hostettler K, et al. Bosentan for patients with steroid-resistant pulmonary sarcoidosis: a randomised controlled trial.
PMID: 31568555 [PubMed - in process]
Source: Swiss Medical Weekly - September 23, 2019 Category: General Medicine Authors: Carratù P, Dragonieri S, Resta O Tags: Swiss Med Wkly Source Type: research

Reply to comment by Carrat ù P, et al. on: Hostettler K, et al. Bosentan for patients with steroid-resistant pulmonary sarcoidosis: a randomised controlled trial.
Reply to comment by Carratù P, et al. on: Hostettler K, et al. Bosentan for patients with steroid-resistant pulmonary sarcoidosis: a randomised controlled trial. Swiss Med Wkly. 2019 Sep 23;149:w20133 Authors: Hostettler KE, Brutsche MH PMID: 31568552 [PubMed - in process]
Source: Swiss Medical Weekly - September 23, 2019 Category: General Medicine Authors: Hostettler KE, Brutsche MH Tags: Swiss Med Wkly Source Type: research

Sarcoid-like Histiocytic Proliferations in Patients With Lymphoma Can Be FDG-avid Concerning for Refractory or Recurrent Disease
Publication date: Available online 30 August 2019Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Zuzan Cayci, Kerem Ozturk, Celalettin Ustun, Aazim K. Omer, Erhan Dincer, Zohar Sachs, Bruce A. Peterson, Michael A. LindenAbstractSarcoidosis has been shown to be associated with increased risk of development of several malignancies including lymphomas. On the other hand, “sarcoid-like reactions” in the absence of other clinical signs of sarcoidosis, have also been described in patients who had been treated with chemotherapy for a wide variety of malignancies. In this article, we report 3 cases who had PET-CT scan...
Source: Clinical Lymphoma Myeloma and Leukemia - September 22, 2019 Category: Cancer & Oncology Source Type: research

Sarcoid-like histiocytic proliferations in lymphoma patients can be PET-avid concerning for refractory or recurrent disease
Publication date: Available online 30 August 2019Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Zuzan Cayci, Kerem Ozturk, Celalettin Ustun, Aazim K. Omer, Erhan Dincer, Zohar Sachs, Bruce A. Peterson, Michael A. LindenAbstractSarcoidosis has been shown to be associated with increased risk of development of several malignancies including lymphomas. On the other hand, “sarcoid-like reactions” in the absence of other clinical signs of sarcoidosis, have also been described in patients who had been treated with chemotherapy for a wide variety of malignancies. In this article, we report 3 cases who had PET-CT scan...
Source: Clinical Lymphoma Myeloma and Leukemia - August 31, 2019 Category: Cancer & Oncology Source Type: research

The Utility of Whole Body 18F-FDG PET-CT in Diagnosing Isolated Cardiac Sarcoidosis: The Western Australian Cardiac Sarcoid Study
This study aims to determine the rate of isolated cardiac involvement with clinically manifest CS using cardiac 18F-FDG PET-CT.
Source: Heart, Lung and Circulation - August 20, 2019 Category: Cardiology Authors: Lauren Giudicatti, James Marangou, David Nolan, Lawrence Dembo, Jay Baumwol, Girish Dwivedi Tags: Original Article Source Type: research

Patient perspectives in sarcoidosis
Purpose of review The review presents an overview of the scientific publications about patient perspectives in sarcoidosis. Recent findings The literature on patient perspectives in sarcoidosis is limited. Patient perspectives in sarcoidosis encompass a myriad of topics that have been addressed to some degree in the literature: patient needs and perceptions, patient-reported burden of sarcoidosis, and patient treatment priorities. Similar findings across studies were high levels of reported fatigue, a need to incorporate psychological support into the treatment plan and easy access to sarcoidosis expert centers. Furth...
Source: Current Opinion in Pulmonary Medicine - August 2, 2019 Category: Respiratory Medicine Tags: SARCOIDOSIS: Edited by Jan C. Grutters and Marc A. Judson Source Type: research

The diagnosis of sarcoidosis
Purpose of review To review the diagnostic approach to sarcoidosis. There is no gold standard diagnostic test, procedure or algorithm for sarcoidosis. The diagnosis is based on a compatible clinical presentation, histologic findings of granulomatous inflammation, exclusion of alternative diseases, and evidence of systemic involvement. Occasionally, there may be exceptions to several of these requirements. Recent findings The diagnostic specificity of several specific clinical features are discussed. Typical histologic findings of sarcoidosis are described. Several diseases that may mimic sarcoidosis are reviewed. Sum...
Source: Current Opinion in Pulmonary Medicine - August 2, 2019 Category: Respiratory Medicine Tags: SARCOIDOSIS: Edited by Jan C. Grutters and Marc A. Judson Source Type: research

Advanced sarcoidosis
Purpose of review Advanced sarcoidosis is an important cause of morbidity and mortality in sarcoidosis. Over the past few years, several studies have been published clarifying the prevalence and severity of this condition. Recent findings Pulmonary involvement is the most common form of sarcoidosis. Increased morbidity and significant mortality is encountered in advanced lung disease. Although many sarcoidosis patients with pulmonary fibrosis have a normal life expectancy, at least 20% develop progression and may die from this complication. Sarcoidosis-associated pulmonary hypertension (SAPH) is an independent cause o...
Source: Current Opinion in Pulmonary Medicine - August 2, 2019 Category: Respiratory Medicine Tags: SARCOIDOSIS: Edited by Jan C. Grutters and Marc A. Judson Source Type: research

Indications for treatment of sarcoidosis
Purpose of review To describe the current knowledge on indications for sarcoidosis treatment. Recent findings Despite the lack of evidence-based recommendations, the sarcoidosis community has adopted the concept of starting systemic anti-inflammatory treatment because of potential danger (risk of severe dysfunction on major organs or death) or unacceptable impaired quality of life (QoL). On the contrary, while QoL and functionality are patients’ priorities, few studies have evaluated treatment effect on patient-reported outcomes. The awareness of long-term corticosteroids toxicities and consequences on QoL and the e...
Source: Current Opinion in Pulmonary Medicine - August 2, 2019 Category: Respiratory Medicine Tags: SARCOIDOSIS: Edited by Jan C. Grutters and Marc A. Judson Source Type: research

Treatment of cardiac sarcoidosis
Purpose of review In sarcoidosis, the appropriate management strategy remains challenging especially because of the lack of confident diagnosis, considerable variability in initial presentation, disease evolution, and outcome. Although asymptomatic patients with limited cardiac involvement have been described to have a benign outcome, cardiac sarcoidosis is associated with high morbidity and mortality and even sudden cardiac death in a significant proportion of patients. Higher morbidity and mortality can be related with both the disease activity and extent of fibrosis. Recent findings Historical series suggested a 5-...
Source: Current Opinion in Pulmonary Medicine - August 2, 2019 Category: Respiratory Medicine Tags: SARCOIDOSIS: Edited by Jan C. Grutters and Marc A. Judson Source Type: research

Nonorgan manifestations of sarcoidosis
Purpose of review The current review discusses the diagnosis and management of nonorgan-related symptoms that commonly arise in the setting of systemic sarcoidosis. Fatigue, small fiber neuropathy (SFN) and neuropsychological symptoms are highlighted. Recent findings The debilitating effects of chronic nonorgan-based symptoms in sarcoidosis have led to recent studies focusing on incidence rates, contributing factors and potential therapeutic strategies. In a web-based survey of over 1000 sarcoidosis patients, the most common symptom was fatigue, which was reported by over 90% of participants, whereas memory loss and c...
Source: Current Opinion in Pulmonary Medicine - August 2, 2019 Category: Respiratory Medicine Tags: SARCOIDOSIS: Edited by Jan C. Grutters and Marc A. Judson Source Type: research

Clustering of immune-mediated diseases in sarcoidosis
Purpose of review Sarcoidosis is an immune-mediated disease of unknown cause. Immune-mediated diseases appear to cluster in patients and in families. We review what is known on this topic for sarcoidosis, and what factors may underlie disease clustering. Recent findings In populations of patients with sarcoidosis, relative risk estimates of Sjögren's syndrome, systemic lupus erythematosus, autoimmune hepatitis, ankylosing spondylitis, multiple sclerosis (MS), celiac disease, autoimmune thyroid disease, and ulcerative colitis, varied between 2.1 and 11.6. In relatives of patients with sarcoidosis, relative risk estima...
Source: Current Opinion in Pulmonary Medicine - August 2, 2019 Category: Respiratory Medicine Tags: SARCOIDOSIS: Edited by Jan C. Grutters and Marc A. Judson Source Type: research