Sarcoidosis is a rare, multisystem granulomatous disease of incompletely understood pathogenesis. Clinically, it shares common features with several systemic and organ-specific autoimmune diseases, although known autoantibodies or useful serologic markers for diagnosis and monitoring of disease activity are lacking. Sarcoidosis can both coexist with or mimic connective tissue diseases or vasculitis. Here, we review possible common etiologic factors between sarcoidosis and autoimmune disease, comparing clinical, laboratory and imaging features.
Autoimmune diseases may precede or follow the diagnosis of sarcoidosis. Overall, the prevalence of both co-existing is unknown because of limited evidence. The presence of autoantibodies in sarcoidosis should raise suspicion of an underlying autoimmune disease that mimics or co-occurs with sarcoidosis. Silica dust exposure has been associated with an increased prevalence of both sarcoidosis and rheumatoid arthritis. In another study, autoimmune thyroid disease, Sjogren's syndrome and ankylosing spondylitis have been reported to be more frequent in sarcoidosis compared with healthy controls.
A systematic diagnostic work-up is necessary to detect overlapping disease features in patients with sarcoidosis. Immune-modulating therapies need to be taken into account as these can induce paradoxical reactions.
aDepartment of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, Germany
bDepartment of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
cAcademic Rheumatology Department, King's College London
dDepartment of Rheumatology, Whittington Hospital, London, United Kingdom
Correspondence to Peter Korsten, Department of Nephrology and Rheumatology, University Medical Center Göttingen, Robert-Koch-Street 40, 37075 Göttingen, Germany. Tel: +49 551 39 8904; e-mail: firstname.lastname@example.org