Walsh & Hoyt: Sarcoidosis: Prognosis

It is estimated that about 80% of patients with sarcoidosis remain asymptomatic throughout the course of the disease. Of the remaining 20% who develop clinical symptoms and signs, more than 90% of whom have only pulmonary manifestations, two-thirds improve spontaneously over 23 years to the point where they have no or only minimal clinical manifestations. Thus, about 7% of patients with sarcoidosis or 33% of patients with symptomatic disease have a course that is complicated by persistent pulmonary disease, extrathoracic disease, or both. Of these patients, most have a smoldering course with little change over 10 years or more. Less than one-half of this group (about 3% of all patients with sarcoidosis or about 10% of those with clinical manifestations) have a progressive course with a fatal outcome.