Sarcoidosis and tuberculosis - a diagnostic and management challenge

Abstract

Background. Because the clinical and histological aspects of sarcoidosis and tuberculosis overlap, diagnosing these two diseases can be extremely difficult. Their differentiation is complicated by the fact that both diseases present as granulomatous disorders that frequently affect the lungs and occasionally other organs. Objective. Reviewing and analyzing the diagnostic difficulties related to sarcoidosis and tuberculosis with an emphasis on clinical presentation, histology, biomarkers, and molecular diagnostics is the study’s main goal. Material and methods: Bibliographic sources were used to synthesize research published between 2020 and 2023 in order to create the proposed aim. Histopathological examination, molecular testing (PCR for mycobacterial DNA), and serum biomarkers (IL-2R, ACE, KL-6, leptin, and ICAM-1) were all given special consideration. Results. Caseating granulomas are diagnostic of tuberculosis, and non-caseating granulomas are indicative of sarcoidosis, according to the review, which found significant overlap in the clinical and radiological characteristics of both disorders. Mycobacterial DNA was found in varying amounts in sarcoidosis patients according to molecular testing. Although the combination of leptin and ICAM-1 showed promise in differentiating, serum indicators lacked enough specificity. Conclusion. Significant difficulties arise from the diagnostic overlap between TB and sarcoidosis. A thorough strategy combining clinical, histological, and cutting-edge diagnostic methods is necessary for a correct diagnosis, even though molecular testing and novel biomarker combinations help to differentiate cases.