The goals of testing are to diagnose sarcoidosis, evaluate its severity, and 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 useful include:
- ACE (angiotensin converting enzyme) - this test is used to help diagnose sarcoidosis, monitor disease activity, and monitor response to treatment. ACE is often elevated in people with sarcoidosis, but it may be increased with other conditions.
- 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 increased concentrations in the blood or urine
- Cerebrospinal fluid (CSF) analysis - when brain or nervous system involvement is suspected
- AFB cultures, sputum cultures, and fungal tests - to help distinguish between sarcoidosis and other conditions that may affect the lungs and cause granulomas
- Chest X-ray - a common and useful test for detecting lung involvement; in people without symptoms, granulomas may first be discovered when they have an X-ray for another reason.
- Lung function tests are performed to evaluate lung involvement and its severity. (For more on these, read Johns Hopkins Medicine Health Library: Pulmonary Function Tests.)
- 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