الفهرس 
Introduction
Chapter (1) Definition & Epidymiology of sarcoidosisOnly 14 pages are availabe for public view
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Abstract
The aim of this study is to evaluate the clinical , laboratory and radiological features of sarcoidosis in our locality and to study similarities and differences from the basic features known worldwide. We can summarize the results in the following :
Our patients were females more than males, with similar age affection above and below 40 years old, and mostly nonsmokers with rare specific exposure.
Nasal symptoms were frequently reported in 14 patients (46%) of the studied group and gastro-esophageal reflux symptoms were present in 17 patients (56.7%) .The main respiratory symptoms were dyspnea grade2 ,productive cough and chest wheeze.General symptoms were frequently noted and the commonest symptom was fatigue and was presents in 21 patients (70%) followed by fever in 18 patients (60%), arthralgia in 15 patients (50%) and weight loss in only 5 patients (16.7%).
We noted ocular manifestations in the form of lacrimal gland swelling in 11 patients (36.7%), dryness of the eye in 7 patients (23.3%), itching in 5 patients (16.7%), eye redness in 5 patients (16.7%) and dropped eye lid in only 2 patients (6.7%).
Fewer CNS symptoms were present in our patients like epileptic fits in two patients (6.7%) and history of facial palsy in another two (6.7%).
Skin manifestations in the form of erythema nodosum was found in 6 patients (20%), but lupus pernio, keloid and skin papules each of them was present in 2 patients (6.7%).
During ultrasound examination of the patients we noted mild hepatomegaly in 9 patients (30%), mild splenomegaly in another 9 patients (30%). Renal stones were detected in two patients (6.7%).
Echocardiographic examination of the studied patients revealed ejection fraction ranged from 65-70 with mean and SD 76.3±2.2 and pulmonary artery systolic pressure ranged from 35.40 with mean and SD37.8±2.6. Left ventricular diastolic dysfunction was noted in 4 patients (13.3%) and pericardial effusion in another 4 patients (13.4%).
The most important laboratory investigation was ESR which was elevated in most patients with range (22-65). Another lab investigations were shown in the table.
X-ray findings in our patients revealed multiple radiological patterns the most of them was bilateral hilar lymphadenopathy which was found in 25 patients (83.4%). Reticulo-nodular shadow, nodular shadow and pleural effusion were only noted in two patients (6.7%). Veiling in chest radiograph was obvious in 9 patients (30.1%). Other chest X-ray findings were linear atelectatic bands in two patients (6.7%) and thick beaded horizontal fissures in three patients (10%).
HRCT characteristics of studied patients revealed evident lymph nodes enlargement the most of them was bilateral hilar lymphadenopathy in 24 patients (80%) ,prevascular lymph nodes in 22 patients (73.3%),subcarinal nodes in 13 patients (43.3%), paratracheal lymphadenopathy in 9 patients(30%). Other HRCH findings were ground glass opacity in 11 patients (36.7%), reticular opacity in 5 patients (16.7%), pericardial effusion in 4 patients (13.3%) and pleural effusion in two patients (6.7%). Many of the cases showed diffuse infiltrations in the CT findings and this was evident in 17 patients (56.7%) but 11 patients showed localized lobar infiltrations (36.7%). Some areas of consolidations were noted in 2 patients (6.7%) and thick beaded right horizontal fissures in three patients (16%).
The diagnosis of our patients was made by various methods. The most important is biopsy and this was done in 17 patients(56.7%) in the form of cervical lymph node biopsy in 8 patients (26.6%),cutaneous biopsy in 2 patients (6.7%),ovarian biopsy in 2 patients (6.7%), and mediastinal biopsy by EBUS in 5 patients (16.7%), other diagnoses were made by Heerford syndrome in two patients(6.7%)and Lofgreen syndrome in 4 patients(13.3%). Seven patients (23.3%) refused biopsy had typical radiological and clinical scenario of sacoidodis.
Both Quantiferon TB and Mantaux tests were done in 17 patients
both tests were positive in 2 patients (11.8%) and negative in 15 patients (88.2%).13 patients refused both tests.
Our patients received proper treatment in the form of oral corticosteroids and /or other immunosuppressant drugs and the outcome of treatment was good response to steroid only in 24 patients(80%),good response to steroid and methotrexate in two patients(6.7%),and poor response to all in two patients(6.7%).The remaining two patients just started steroid therapy.