Sarcoidosis presenting with glazy mucoid sputum and dyspnea: a case report.
BACKGROUND
Patients with pulmonary sarcoidosis commonly present with a dry cough; a productive cough suggests a complicating airway infection or an alternative diagnosis such as tuberculosis or bronchiectasis.


CASE PRESENTATION
A 36-year-old European (Frisian) woman recently diagnosed with pulmonary sarcoidosis presented with debilitating exertional dyspnea and cough productive of glazy mucoid sputum. Several different attempts including video-assisted thoracoscopic biopsies failed to reach a second or alternative diagnosis including an infectious, autoimmune or collagen-vascular condition. She responded to steroids but with poor tolerance to this treatment, which could not be tapered. After she was started on anti-tumor necrosis factor alpha (TNF-α) therapy with infliximab, 200 mg at three-monthly intervals, she has been fine for well over a decade.


CONCLUSIONS
In this patient with sarcoidosis who had a productive cough accompanied by fever, an extensive workup and prolonged follow-up, an alternative or second diagnosis could be ruled out; we therefore conclude that this highly unusual presentation is part of the clinical spectrum of sarcoidosis.
['Al-Kailany|Wud|W|', 'Timens|Wim|W|', 'Venmans|Ben|B|', 'de Jonge|Gonda|G|', 'van der Werf|Tjip S|TS|']
D000328:Adult D004417:Dyspnea D005260:Female D006801:Humans D000069285:Infliximab D012507:Sarcoidosis D017565:Sarcoidosis, Pulmonary D013183:Sputum
Sarcoidosis Mucoid sputum Anti-tumor necrosis factor alpha