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Invited Commentary
December 2017

Sarcoid, Bayes, and the Challenges of Laboratory Testing for Uveitis

Author Affiliations
  • 1Departments of Ophthalmology, Biological Structure, and Pathology, University of Washington School of Medicine, Seattle
JAMA Ophthalmol. 2017;135(12):1359-1360. doi:10.1001/jamaophthalmol.2017.4789

Sarcoidosis was first described as an erythema nodosum–like skin condition, lupus pernio, by Jonathan Hutchinson in 1877. Histologic analysis of biopsies of affected skin revealed a unique pathology: the noncaseating granuloma. In the ensuing decades, it was recognized that these granulomas could occur in many organ systems, suggesting that sarcoidosis is a systemic disease. The first description of uveitis associated with sarcoidosis dates to 1909. Sarcoidosis is not uncommon, with a global incidence rate of about 16 in 100 000 annually and an incidence rate in the African American population about twice that. About 30% of cases will feature ocular involvement, typically uveitis. In a representative long-term study of the causes of uveitis in a busy tertiary uveitis referral clinic, 14% of uveitis was attributable to sarcoidosis.1

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