Internal Medicine


  • multisystem disease
  • characterized by non-caseating granulomas
  • etiology is unknown


  • Lungs: dry, non-productive cough, dyspnea, chest pain
  • Eyes: blurry vision, conjunctivitis, eye pain, uveitis (common), iritis
  • Skin: erythema nodosum, papules, macules, nodules, lupus pernio
  • Heart: arrhythmias, cardiomyopathy


  • diagnosis of exclusion
  • initial labs: CBC, serum chemistry (ALT, AST, ALP, BUN, Cr, Ca, other electrolytes), urinalysis, 24 h urine excretion of calcium, CRP, ESR, tuberculin skin test
  • imaging: CXR, ECG
  • pulmonary function tests: spirometry, diffusion capacity of carbon monoxide (DLCO)- single breath
  • biopsy (skin, lymph nodes or conjunctiva) of affected area, and if no suitable area is present then bronchoscopy with transbronchial biopsy.


  • Corticosteroids are the mainstay therapy when required. Given if severe lung disease, involvement of eyes/ CNS/ heart, or hypercalcemia.
  • Prednisone 40 mg daily for 8 to 12 weeks then taper to 10 mg every other day over 8 to 12 months. <<source: Ferri’s clinical advisor 2016>>