Comparison between sarcoidosis and Wegener granulomatosis
| Sarcoidosis | Wegener granulomatosis | |
| Clinical presentation | ||
| Upper airway | Occurs in <10% of cases | Extremely common |
| Lung | Common Adenopathy Diffuse infiltrates, usually upper lobes | Common Nodular infiltrates, sometimes with cavities Infiltrates localised to areas of haemorrhage, often lower lobe |
| Eye | Uveitis, retinitis, optic neuritis | Episcleritis |
| Skin | Maculopapular lesions | Vasculitic lesions |
| Lupus pernio | Occasionally seen | |
| Kidney | Glomerulopnephritis rare, renal failure usually due to hypercalcaemia | Focal necrotising glomerulitis in over half of cases |
| Neurological disease | 10% of patients. Often mass seen on MRI | Up to 30% of cases will have lesions. Usually due to vasculitic lesions |
| Joints | Uncommon. Can see specific bone cysts | Uncommon |
| Tracheal/proximal airway stenosis | Rare | Common |
| ANCA | Negative | Positive in >80% of cases |
| ACE | Positive in >60% of new cases | Negative |
| Treatment | ||
| Corticosteroids | Drug of choice for initial management | Supportive but not used for maintenance therapy |
| Methotrexate | Effective | Effective |
| Azathioprine | Effective | Effective |
| Cyclophosphamide | Reserved for refractory cases | Treatment for extensive disease |
| Anti-TNF therapy | Effective for refractory disease | Not effective for most patients |
| Ritixumab | Effectiveness unknown | Effective for refractory cases |
ANCA, antineutrophil cytoplasmic antibody; TNF, tumour necrosis factor.