Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for follow-up of biopsy-proven sarcoidosis. Reports persistent non-productive cough, exertional dyspnea (mMRC grade [X]), and intermittent fatigue. Denies chest pain, hemoptysis, or constitutional symptoms (fever, night sweats, weight loss). Current pulmonary function tests (PFTs) show [restrictive/obstructive/normal] pattern. Chest imaging confirms Stage II disease (bilateral hilar lymphadenopathy with pulmonary parenchymal infiltrates).
Clinical Examination Findings
Vitals: Stable. HEENT: No cervical or supraclavicular lymphadenopathy. Skin: No evidence of lupus pernio, erythema nodosum, or maculopapular lesions. Respiratory: Bilateral clear to auscultation or [fine bibasilar crackles/wheezing]. Cardiovascular: Regular rate and rhythm, no murmurs, S1/S2 normal. Extremities: No peripheral edema or clubbing.
Treatment Protocol
Plan: 1. Initiate/Continue systemic corticosteroids (Prednisone [X] mg daily with taper). 2. Monitor for steroid-related side effects (glucose, blood pressure, bone density). 3. Consider steroid-sparing agents (Methotrexate/Azathioprine) if refractory. 4. Serial PFTs and chest imaging every [X] months. 5. Ophthalmology referral for uveitis screening.