For the development of pulmonary sarcoidosis the appearance of non-specific symptoms is characterized. These in particular include: malaise, anxiety, fatigue, general weakness weight loss, loss of appetite, fever, sleep disturbances, night sweats. Hilar form of the disease is characterized in a half of patients with the absence of any symptoms. Meanwhile, the other half tends to highlight the symptoms of the following type: weakness, soreness in the chest, pain in the joints, dyspnea, wheezing, cough, temperature increase, the appearance of erythema nodosum that is the inflammation of the subcutaneous fat and skin vessels. With regard to the form of sarcoidosis as mediastinal-pulmonary form, it is characterized by the following symptoms: cough, dyspnea, pain in the chest, auscultation determines the presence of crepitation, scattered dry and moist rales. The presence of extrapulmonary manifestations of the disease in the form of damage to eyes, skin, lymph nodes, the defeat of the salivary glands parotid Herford’s symptom.
Acute sarcoidosis is accompanied by changes in laboratory blood parameters indicative of the inflammatory process: a moderate or significant increase in erythrocyte sedimentation rate, leukocytosis, eosinophilia, lymph and monocytosis. The initial increase in titers α- and β-globulin with the development of sarcoidosis is replaced by an increase in the content of γ-globulins.
Characteristic changes in sarcoidosis are identified with X-ray light, CT or MRI of lungs - defined tumor lymph node enlargement, mainly in the roots, symptom of "scenes" (imposing shadow nodes at each other), alopecia dissemination, fibrosis, emphysema, cirrhosis of the lung tissue. More than half of patients have a positive response to Kveim reaction - the appearance of purplish-red nodule after intradermal administration of 0.1-0.2 ml of sarcoid-specific antigen.
Indirect and direct signs of sarcoidosis may be detected during the bronchoscopy with biopsy: vasodilation, signs of increased lymph nodes in the bifurcation zone, deforming or atrophic bronchitis, sarcoid lesions of the bronchial mucosa in the form of patches, bumps and warty growths.
The most informative method of diagnosis of sarcoidosis are biopsies obtained during bronchoscopy, mediastinoscopy, transthoracic puncture, open lung biopsy. Morphologically biopsy determines the elements of epithelioid granulomas without necrosis and signs of perifocal inflammation.