Sarcoidosis involves a diverse range of clinical manifestations1-4

Sarcoidosis is a multi-organ granulomatous disease that has many clinical characteristics and can involve any organ system1-4

Can involve many clinical manifestations, such as1:

  • Acute sarcoidosis (Löfgren syndrome)
  • Pulmonary sarcoidosis
  • Chronic cutaneous sarcoidosis
  • Hematologic sarcoidosis
  • Musculoskeletal sarcoidosis, including arthritis and myopathy
  • Neurosarcoidosis
  • Renal involvement

Affects many major organ systems1-4:

  • Lungs
  • Neurologic
  • Myocardial and vascular
  • Kidney
  • Skin
  • Ocular

Treatment strategy should consider the multisystem nature of the disease and its comorbidities3

Sarcoidosis can coexist with many diseases, including1-4:

  • Arthritis/periarthritis
  • Rheumatoid arthritis
  • Ankylosing spondylitis (AS)
  • Systemic lupus erythematosus (SLE)
  • Polymyositis
  • Granulomatous uveitis
  • Osseous sarcoidosis

Sarcoidosis involves many immune pathways

Based on a review of articles by doctors Baughman, Gerke, and Iannuzzi, it is believed that granuloma formation results from an exaggerated immune response to unknown antigens.5-7

  • Granulomas are typically composed of macrophages, epithelioid cells, multinucleated giant cells, and T-cell lymphocytes5-7
  • Various cytokines, such as interleukin-2, interferon-γ, and tumor necrosis factor-α, are released throughout the process, leading to granuloma inflammation and progression5-7
Hypothesized Immunopathogenesis of Sarcoidosis


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  • Acthar should never be administered intravenously
  • Administration of live or live attenuated vaccines is contraindicated in patients receiving immunosuppressive doses of Acthar
  • Acthar is contraindicated where congenital infections are suspected in infants
  • Acthar is contraindicated in patients with scleroderma, osteoporosis, systemic fungal infections, ocular herpes simplex, recent surgery, history of or the presence of a peptic ulcer, congestive heart failure, uncontrolled hypertension, primary adrenocortical insufficiency, adrenocortical hyperfunction or sensitivity to proteins of porcine origins


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H.P. Acthar® Gel (repository corticotropin injection) is an adrenocorticotropic hormone (ACTH) analogue used for:

  • Treatment during an exacerbation or as maintenance therapy in selected cases of systemic dermatomyositis (polymyositis)
  • Treatment during an exacerbation or as maintenance therapy in selected cases of systemic lupus erythematosus
  • The treatment of symptomatic sarcoidosis
  • Adjunctive therapy for short-term administration (to tide the patient over an acute episode or exacerbation) in rheumatoid arthritis, including juvenile rheumatoid arthritis (selected cases may require low-dose maintenance therapy)