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Abstract：
Background: The diagnosis of sarcoidosis is not standardized but is based on three major criteria: a compatible clinical presentation, finding nonnecrotizing granulomatous inflammation in one or more tissue samples, and the exclusion of alternative causes of granulomatous disease. There are no universally accepted measures to determine if each diagnostic criterion has been satisfied; therefore, the diagnosis of sarcoidosis is never fully secure.Methods: Systematic reviews and, when appropriate, meta-analyses were performed to summarize the best available evidence. The evidence was appraised using the Grading of Recommendations, Assessment, Development, and Evaluation approach and then discussed by a multidisciplinary panel. Recommendations for or against various diagnostic tests were formulated and graded after the expert panel weighed desirable and undesirable consequences, certainty of estimates, feasibility, and acceptability.Results: The clinical presentation, histopathology, and exclusion of alternative diagnoses were summarized. On the basis of the available evidence, the expert committee made 1 strong recommendation for baseline serum calcium testing, 13 conditional recommendations, and 1 best practice statement. All evidence was very low quality.Conclusions: The panel used systematic reviews of the evidence to inform clinical recommendations in favor of or against various diagnostic tests in patients with suspected or known sarcoidosis. The evidence and recommendations should be revisited as new evidence becomes available.
摘要：
背景：结节病的诊断尚未标准化，但基于三个主要标准：兼容的临床表现，在一个或多个组织样本中发现非坏死性肉芽肿性炎症，并排除肉芽肿病的替代原因。没有普遍接受的措施来确定每个诊断标准是否得到满足；因此，结节病的诊断从未完全可靠。方法：系统评价和，在适当的时候,进行荟萃分析以总结最佳的可用证据。证据是使用建议分级进行评估的，评估,发展,和评估方法，然后由多学科小组讨论。在专家小组权衡了理想和不良后果之后，制定了支持或反对各种诊断测试的建议并进行了分级。估计的确定性，可行性,和可接受性。结果：临床表现，组织病理学,并对排除替代诊断进行了总结。根据现有证据,专家委员会对基线血清钙检测提出了1个强烈推荐，13条件性建议，和1个最佳实践声明。所有证据的质量都很低。结论：该小组使用对证据的系统评价来提供临床建议，以支持或反对怀疑或已知结节病患者的各种诊断测试。随着新证据的出现，应重新审视证据和建议。
