**1. Introduction**

Sarcoidosis is a rare unknown etiology multiorgan granulomatous disease. The most affected organs by the pathology are the lungs, skin, or lymph nodes (especially intrathoracic lymph nodes). Less commonly are involved eyes, liver, heart, and brain, in a percentage ranging between 25 and 50%. Any organ, however, can be involved by sarcoidosis [1].

Signs and symptoms depend on which organs are affected and the presentation varies with the extent and severity of organ involvement [2].

The first state is *asymptomatic phase* (incidentally detected on chest imaging), approximately in 5% of patients. Then, *systemic complaints* are possible, which manifest itself with fever and anorexia (about 45% of cases). The most common condition (about 50% of cases) is *pulmonary complaints* with clinical presentation of dyspnea on exertion, cough, chest pain, and rarely hemoptysis. Pulmonary findings usually are normal but crackles may be audible; furthermore in a little part of patients exertional oxygen desaturation may be present [2].

Another possible clinical presentation is *Löfgren syndrome*, which consists in fever, bilateral hilar lymphadenopathy, erythema nodosum (an acute, nodular, cutaneous rash), and arthritis with polyarthralgias and is common in Scandinavian patients, but quite uncommon in African-American and Japanese patients. *Cutaneous involvement* may be present not only with erythema nodosum associated with Löfgren syndrome, but also with lupus pernio, violaceous rash on the cheeks or nose (quite common) and maculopapular plaques (quite uncommon) [2].

*Ocular involvement* is also possible, which may lead to blindness for untreated anterior or (most frequent) posterior granulomatous uveitis, conjunctival lesions and scleral plaques.

Other uncommon possible manifestations are [2] *nervous system involvement* with lymphocytic meningitis (rare), cranial nerve palsies, hypothalamic/pituitary dysfunction (rare) with diabetes insipidus and myelopathy; *heart failure* from cardiomyopathy (rare) or heart block and sudden death; *osseous involvement* with arthritic syndromes; *blood abnormalities*: anemia, leukopenia, thrombocytopenia and hemolytic anemia with or without splenomegaly (without splenomegaly may reflect bone marrow involvement); *gastrointestinal and genitourinary involvement* (rare): hepatomegaly, cholestasis, portal hypertension, Crohn's disease, pancreatic involvement, nephrocalcinosis, vulva itchiness and male infertility (rare); *exocrine and endocrine manifestations* with hyperprolactinemia, amenorrhea, galactorrhea, or nonpuerperal mastitis in women; hypercalciuria and hypercalcemia likely result from the increased 1,25-dihydroxy vitamin D production (rare) [2].
