What tests are used to diagnose sarcoidosis?
We can diagnose sarcoidosis by doing a biopsy on an affected organ that shows the granuloma formation. In children, the biopsy is commonly taken from the location that is easiest, safest and most convenient. It is important to exclude other diseases that can also have multisystem granulomas such as tuberculosis, atypical tuberculosis, fungal infections such as histoplasmosis or blastomycosis, drug reactions or other immunologic reactions such as hypersensitivity pneumonitis.
A diagnosis of sarcoidosis requires the presence of specific symptoms, signs, tissue biopsy from an affected organ system and exclusion of other conditions that may be similar in appearance.
When there is concern for lung involvement, we commonly order a chest X-ray. The results are usually available the same day.
For children with suspected pulmonary sarcoidosis who are 5 years of age and older, we commonly perform pulmonary function testing. This consists of blowing hard and fast into a computer with nose clips on. The results are also available the day of the test.
For children 8 years and older with suspected pulmonary sarcoidosis, we also perform lung volume measurements and diffusing capacity tests. These tests require sitting in a pressurized, clear, air-tight box and doing simple breathing exercises. The results of the lung volume and diffusing capacity tests are also available the same day of the tests.
Depending on the results of the chest X-ray and the breathing tests, we may order a CT scan of the chest or other organs.
How do we make a diagnosis for sarcoidosis?
The diagnosis of sarcoidosis can be challenging and often requires the expertise of several specialties including pulmonology (lung doctors), infectious diseases, rheumatology, radiology, ophthalmology (eye doctors), dermatology (skin doctors) and pediatric surgery. Your child’s primary care physician can refer your child to our program for sarcoidosis evaluation and treatment. We will coordinate care with the group of specialists that is most appropriate for your child. Collectively, we can diagnose sarcoidosis and exclude other diseases.