The goals with testing are to diagnose sarcoidosis, evaluate its severity, and to monitor its course over time. Testing is also used to distinguish sarcoidosis from conditions with similar symptoms and from conditions that are also associated with the development of granulomas – such as tuberculosis and some fungal infections.
Tissue biopsy is the primary test used to confirm a diagnosis of sarcoidosis; characteristic changes in the structure of the tissue can be seen under the microscope. Other laboratory tests are not specific for sarcoidosis, but they are helpful in assessing disease activity, looking for damage to individual organs, and ruling out other diseases that may cause similar problems Tests that may be ordered include:
- ACE (Angiotensin converting enzyme) - often elevated with sarcoidosis but may be increased with other conditions; this test is used to help diagnose sarcoidosis, monitor disease activity, and monitor response to treatment.
- Liver Panel or CMP (Comprehensive Metabolic Panel) - a group of tests used to evaluate liver and/or kidney function, to determine if those organs are affected
- CBC (Complete Blood Count) - may be ordered to evaluate red and white blood cell changes
- ESR (Erythrocyte Sedimentation Rate) - sometimes ordered to detect inflammation
- Calcium - to detect increases in the blood or urine
- CSF analysis - an evaluation of the cerebrospinal fluid when brain or nervous system involvement is suspected
- AFB cultures, sputum cultures, and fungal tests - to help distinguish between sarcoidosis and other conditions associated with the lungs and with granuloma development
- X-ray - one of the primary tests used to detect lung involvement; granulomas may be initially detected in people without symptoms who have an X-ray for another reason.
- Lung function tests are performed to evaluate lung involvement, lung capacity, and condition severity. (For more on these, visit the Johns Hopkins Medicine Pulmonary Function Laboratory website.)
- CT (Computed Tomography), MRI (Magnetic Resonance Imaging), gallium scan, or other imaging scans are sometimes ordered to help diagnose and evaluate sarcoidosis. (Visit Radiologyinfo.org for additional details on these imaging tests.)
- EKG (electrocardiogram) - sometimes ordered when heart involvement is suspected.