Systemic disorders with rheumatic manifestations: Edited by Geraldine McCarthySarcoidosis and the rheumatologistTorralba, Karina D; Quismorio, Francisco P JrAuthor Information Division of Rheumatology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA Correspondence to Karina D. Torralba, MD, Division of Rheumatology, Keck School of Medicine, University of Southern California, 2011 Zonal Avenue, HMR 711, Los Angeles, CA 90033, USA Tel: +1 323 442 1946; fax: +1 323 442 2874; e-mail: [email protected] Current Opinion in Rheumatology: January 2009 - Volume 21 - Issue 1 - p 62-70 doi: 10.1097/BOR.0b013e32831dde88 Buy Metrics Abstract Purpose of review The purpose of this review is to discuss challenges in the diagnosis and treatment of sarcoidosis by rheumatologists. Recent findings Sarcoidosis is a heterogeneous multisystem granulomatous disease. Rheumatologists are faced with multiple challenges in the management of this disease. Features that can have similarities to many rheumatic diseases are being increasingly reported. There are many reports of sarcoidosis coexisting with or mimicking rheumatic diseases such as systemic lupus erythematosus, rheumatoid arthritis, and ankylosing spondylitis. Musculoskeletal features of sarcoidosis can also mimic infection and malignancy. Biomarkers for the diagnosis and monitoring of treatment of response are lacking. Tumor necrosis factor (TNF) inhibition therapy is a viable alternative for immunodulation for various manifestations. However, increased vigilance is needed, as there are also emerging reports of drug-induced sarcoidosis in association with the use of anti-TNFα agents and other medications. This article reviews these diagnostic and treatment challenges that rheumatologists face. Summary Many questions remain to be answered. More studies looking at the reliability of certain serological and radiological biomarkers are needed. Issues concerning the safety of the use of biological response modifiers in inducing sarcoidosis need further study. © 2009 Lippincott Williams & Wilkins, Inc.