DISRs may resolve after discontinuation of the offending agent and recur if the agent is reintroduced. Among the medications that more commonly cause DISR are immune checkpoint inhibitors, highly active anti-retroviral therapies, tumor necrosis factor- α antagonists and BRAF inhibitors. It’s important to keep drug reactions in mind when evaluating patients with sarcoid-like symptoms and signs.
In Sum
A great deal remains to be discovered about sarcoidosis. For rheumatologists and other clinicians, this disease will continue to be part of the deferential for many patients, and hopefully, the coming years will allow for its effective diagnosis and treatment.
Jason Liebowitz, MD, completed his fellowship in rheumatology at Johns Hopkins University, Baltimore, where he also earned his medical degree. He is currently in practice with Skylands Medical Group, N.J.
References
- Kouranos V, Tzelepis GE, Rapti A, et al. Complementary role of CMR to conventional screening in the diagnosis and prognosis of cardiac sarcoidosis. JACC Cardiovasc Imaging. 2017 Dec;10(12):1437–1447.
- Pefkianaki M, Androudi S, Praidou A, et al. Ocular disease awareness and pattern of ocular manifestation in patients with biopsy-proven lung sarcoidosis. J Ophthalmic Inflamm Infect. 2011 Dec;1(4):141–145.
- Gottlieb JE, Israel HL, Steiner RM, et al. Outcome in sarcoidosis. The relationship of relapse to corticosteroid therapy. Chest. 1997 Mar;111(3):623–631.
- Rizzato G, Montemurro L, Colombo P. The late follow-up of chronic sarcoid patients previously treated with corticosteroids. Sarcoidosis Vasc Diffuse Lung Dis. 1998 Mar;15(1):52–58.
- Judson MA. Advances in the diagnosis and treatment of sarcoidosis. F1000Prime Rep. 2014 Oct 1;6:89.
- Flaherty KR, Wells AU, Cottin V, et al. Nintedanib in progressive fibrosing interstitial lung diseases. N Engl J Med. 2019 Oct 31;381(18):1718–1727. Epub 2019 Sep 29.