Sarcoidosis

Map the organ involvement - Sarcoid is only as relevant as the systems it hits; review PFTs and chest imaging, an ECG and echo, and an airway exam before planning.

Airway involvement - Laryngeal or endobronchial granulomas can cause a difficult airway or narrowing; ask about hoarseness or stridor and be prepared.

Cardiac sarcoid - Can cause heart block and ventricular arrhythmias — review the ECG, ask about syncope, and be ready to pace or treat arrhythmias.

Pulmonary restriction - Where lungs are involved, expect restrictive physiology and reduced reserve; ventilate protectively.

Steroids and hypercalcemia - Many are on chronic steroids (consider stress-dose coverage) and can be hypercalcemic; check and correct.

Sarcoidosis is a multisystem granulomatous disease of unknown cause that most often affects the lungs and lymph nodes but can involve the heart, airway, nervous system, and other organs.

Pulmonary involvement causes restrictive disease and sometimes airway granulomas or distortion; cardiac involvement causes conduction block and arrhythmias; laryngeal involvement can complicate the airway; hypercalcemia occurs. The anesthetic implications depend entirely on which organs are involved.