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In Reply: In reponse to Drs Deeb and Otteson, sarcoidosis can affect every organ system and cause myriad nonspecific signs and symptoms.

The frequency of reported symptoms of sarcoidosis observed by individual practitioners appears to be strongly influenced by the patient population and type of practice. Previous reports suggest that only 1% to 4% of patients with sarcoidosis develop sinonasal involvement.^1-3 The high prevalence of sinonasal symptom reported by Deeb and Otteson are much higher and serve as a reminder that there is significant variation in the rate of common and nonspecific manifestations.

An important source of delay in diagnosis in patients with sarcoidosis are attempts at empirical therapy for other conditions to treat these nonspecific signs and symptoms.⁴ Because the upper aerodigestive and sinonasal tracts are affected in many systemic inflammatory conditions, early consideration for consultation or biopsy of these areas may facilitate timely diagnosis and initiation of appropriate . . . [Full Text of this Article]

Karl W. Thomas, MD; Gary W. Hunninghake, MD
University of Iowa
Iowa City

RELATED ARTICLE

Early Diagnosis of Sarcoidosis
Ziad E. Deeb and Todd D. Otteson
JAMA. 2003;290(11):1454.
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