Sarcoidosis&nbsp;&nbsp;&nbsp;

How do you workup patients with neuropathy suspected to be secondary to sarcoid?

Is a biopsy or EMG helpful in confirming the etiology? What is the best treatment for sarcoid neuropathy?

Is there a role for the use of transient elastography (FibroScan) to monitor liver fibrosis in patients on long term methotrexate?

How would you manage cardiac sarcoid with intolerance/contraindications to methotrexate, azathioprine, and mycophenolate/mycophenolic acid and that has proven refractory to adalimumab and infliximab as determined by PET?

How do you approach medication management in biopsy-proven pulmonary sarcoidosis with disease stable for over 2 years on hydroxychloroquine and low dose prednisone?

Do you discontinue HCQ?

What is your approach to tapering therapy in patients with pulmonary sarcoidosis who are asymptomatic with stable pulmonary function and imaging?

What serologic biomarkers do you send to assess for sarcoidosis at baseline and/or during flares, in patients where it may correlate with disease activity?

Specifically, do you check for any of these: ACE, Vitamin D 1,25, serum lysozyme, soluble IL2 or Adenosine deaminase levels?

How do you approach management of adult patients with CVID and sarcoid-like syndrome?

Do you consider skin involvement associated with tattoos to be a marker of disease activity and an indication to start treatment in a patient with sarcoidosis?

How do you approach treating and monitoring sarcoidosis manifested by maxillary bone/teeth loss without other symptoms?

How would you manage asymptomatic osseous sarcoidosis of the lumbar spine without any other systemic involvement?

Would you use with DMARDs/biologics or monitor?

What is your approach for disease activity monitoring in patients with sarcoidosis?

Do you consider pulmonary hypertension related to sarcoidosis to be an indication to start steroids?

Do you use biomarkers or PET scanning to stratify patients who may benefit most from therapy?

Is it safe to combine mycophenolate and adalimumab for management of pulmonary sarcoidosis in a patient that could not tolerate methotrexate?

What is your approach to monitoring patients with cardiac sarcoid while tapering immunosuppression?

Do you obtain serial cardiac PET scans?

What is your approach to a patient who has a cardiac PET scan suggestive of sarcoid but no other supporting evidence of a diagnosis of sarcoid?

Do you typically push for myocardial biopsy in this case?

How do you approach treating mild hypercalcemia in patients with sarcoidosis?

How do you treat sarcoidosis associated hypercalcemia in a patient with adenopathy and no other signs of systemic involvement?

Do you continue methotrexate while starting TNFi therapy in patients with refractory pulmonary sarcoidosis?

What is your approach to therapy for pulmonary sarcoidosis resistant to methotrexate?

Is there a role for the use of inhaled corticosteroids in patients with pulmonary sarcoidosis who have stage II or III disease with abnormal lung function but only mild respiratory symptoms?

Do you utilize soluble IL-2 receptor or ACE levels as serum biomarkers to monitor disease activity in pulmonary sarcoidosis?

How do you treat patients with sarcoid who have persistent symptoms after an initial 6 week course of corticosteroids?

How do you treat multisystem sarcoidosis refractory to methotrexate, humira, and remicade?

How would you approach asymptomatic hepatic sarcoid?

Multiple lesions on PET

What steroid sparing agent do you use for treatment of cardiac sarcoidosis?

Does the type of cardiac involvement impact this choice?

How do you assess transaminitis in a patient with sarcoidosis with known liver involvement being treated with methotrexate?

How do you manage calcium and vitamin D supplementation in patients with sarcoidosis on chronic steroids?