Walsh & Hoyt: Sarcoidosis: Etiology

The cause of sarcoidosis is unknown. Possible etiologies include noninfectious environmental exposures, infectious agents, or an autoimmune mechanism in a genetically susceptible host. A recently completed major multicenter study in the United States on the etiology of sarcoidosis, called ACCESS (A Case-Controlled Etiologic Study of Sarcoidosis) recruited 720 biopsy-proven cases of sarcoidosis. The study concluded that there was a lack of association with several exposures previously linked to sarcoidosis, including exposure to wood or inorganic dusts, metals, or pine pollen. The lack of evidence for a dominant exposure that significantly raises the risk of sarcoidosis strongly suggests that it is not an environmental disorder.