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Sarcoidosis is a granulomatous disease of unknown etiology that can affect any organ. Management of sarcoidosis patients with the potential for multi-organ involvement can be complex and require the expertise of multiple specialties. The goal of this review is to discuss clinical, imaging and epidemiologic features of organ involvement in sarcoidosis, treatment strategies, and which patients are appropriate for referral to a clinic dedicated to the management of patients with sarcoidosis. Epidemiology Sarcoidosis is a granulomatous inflammatory disease of unknown etiology that can affect any organ. Management of sarcoidosis patients with the potential for multi-organ involvement can be complex and may require the expertise of multiple specialties, but the initial recognition of the disease in its various forms often falls to Primary Care Physicians. There is substantial yearly health care cost, with an average patient cost of $18,663, and $93,201 for the top 5% per year. Sarcoidosis an area of opportunity for improving both patient outcomes and decreasing healthcare costs [1]. The prevalence of sarcoidosis is increasing in the United States, with 185,000 patients seeking out medical care annually [1]. There is significant regional variation in the prevalence of disease, with the highest rates occurring in the Northeast, South and Midwest. In the U.S., sarcoidosis is more common in females and African Americans, but can be seen in all racial and ethnic groups. There tends to be two peaks of incidence, one at about age 30 and another at about age 65. Fifty five percent of patient diagnosed with sarcoidosis are over 55 years of age at the time of diagnosis [2]. The cause of sarcoidosis is not well delineated. It is postulated that there is an environmental trigger of the disease, which results in granulomatous inflammation with a predominance of T-cell helper lymphocytes [3]. There is increasing evidence that genetics play an important role in the pathogenesis, and certain HLA subtypes are associated with disease risk as well as clinical phenotype. In pulmonary sarcoidosis, T-cell lymphocytic alveolitis precedes *Corresponding author: W Ennis James, Assistant Professor, Clinic Director, Susan Pearlstine Sarcoidosis Center of Excellence, Pulmonary and Critical Care Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, CSB 816; MSC 630, Charleston, SC 29425, USA, Tel: 843-792-3167, E-mail: jamesw@musc.edu REVIEW ARTICLE

Sarcoidosis: The Organs Involved. A Primer for Primary Care Physicians