- What is the reason for suspicion of this diagnosis?
- Where should the referral be sent (please see below)?
What type of specialist depends on the organ manifestations
- Mainly joint affection: Rheumatologist
- Pulmonary abnormalities mainly: Lung specialist
- Liver manifestation must be clarified: Gastroenterologist
- Cardiac disorders: Cardiologist
- Eye: Ophthalmologist
- Skin: Dermatologist
- What typical organ symptoms?
- General condition is affected (night sweat / some fever, fatigue, weight loss)?
- Enlarged lymph nodes by palpation
- Heart failure and / or rhythm disturbance
- Auscultation of lungs
- X-ray examination or CT examination of lungs (Enlarged hilus glands or Interstitial pulmonary disease)
- Lung function tests
- Preferably with DLCO / TLCO (gas diffusion)
- Auscultation of heart
- ECG (rhythm disturbances)
- Blood sedimentation rate (ESR) and CRP (moderate increase)
- Leukocytes (Leukopenia among 5 - 10%)
- ACE (angiotensin converting enzyme increased by generalized disease)
- IgG (low among 80%)
- Calcium (increased)
- Alkaline phosphatase and liver enzymes (increased)
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