Table 1.

Serious cardiopulmonary complications of fibrotic pulmonary sarcoidosis

	Specific Diagnosis	Clues to Diagnosis	Treatment
Airway Disease	Airflow obstruction Bronchiectasis Endobronchial stenosis due to intraluminal narrowing or extrinsic compression	Wheezing, reduced FEV1/FVC Cough, sputum, positive cultures, bronchial distortion or bronchiectasis on imaging Cough, fixed wheeze, localized end expiratory rhonchi, positional dyspnea, obstructive atelectasis on imaging	Bronchodilators, inhaled corticosteroids Airway clearance measures (Nebulized) antibiotics as indicated Systemic corticosteroids and/or steroid sparing agents, bronchoscopy with balloon dilatation and/or stenting for refractory lesions
Aspergillus Syndromes	Simple aspergilloma Chronic pulmonary aspergillosis	CT imaging Massive hemoptysis Fever, weight loss, Elevated IgG aspergillus	Observation Bronchial artery embolization Anti-fungal therapy
Pulmonary vascular disease	Pulmonary arterial hypertension* Left heart disease	Disproportionate reduction in DLCO, dyspnea out of proportion to lung disease Elevated BNP, echocardiogram	Oxygen, Vasodilators Treat diastolic and systolic dysfunction as indicated

^*Requires right heart catheterization for diagnosis