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  • Sarcoidosis is a multisystem granulomatous disorder of unknown etiology that is characterized by presence of noncaseating granulomas in involved organs. It initially presents with one or more of the following abnormalities:

    • Bilateral hilar adenopathy

    • Pulmonary reticular opacities

    • Skin, joint, and/or eye lesions




  • Potential difficult airway (laryngeal/tracheal granulomatous disease. nasal mucosal sarcoidosis) 

  • Multisystem granulamotous disease: 

    • Pulmonary

      • A/W Tree: Endobroncial sarcoid, laryngeal sarcoidosis/stenosis

      • Pulmonary fibrosis, pHTN and cor-pulmonale, ↓ DLCO 

    • CVS: 

      • Conduction defects, CHF, restrictive CM, MR from pap muscle involvement, systolic/diastolic function 

    • CNS: central DI (granulomas), dementia, encephalopathy, seizures, polyneuropathy 

    • GI: Hepatomegaly & liver dysfunciton 

    • Metabolic derrangement: Hypercalcemia 

  • Medications: maybe on steroid Rx → stress dose 


  • Anticipate potential difficult airway 

  • Manage potential cardiomyopathy/AICD 

  • Appropriate ventilatory strategy for restrictive lung disease and pulmonary fibrosis 

  • Avoid exacerbation of cor pulmonale and pulmonary hypertension 

  • Consider stress dose steroids 

  • Anticipate complications: prolonged NMB, hypercalcemia, arrhythmias, etc


  • Sarcoidosis and anaesthesia.  BJA Education, Volume 16, Issue 5, May 2016, Pages 173–177

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