Sarcoidosis: an underrecognised cause for bullous lung disease?

A 35-yr-old Caucasian female was admitted with a 2-week history of rapidly progressive dyspnoea on minimal exertion. She denied any associated cough, chest pain or systemic symptoms. She gave a background of a 5-yr history of dyspnoea on moderate exertion, with intermittent cough, but no diurnal variation. This had been previously attributed to asthma and she had been maintained on inhaled corticosteroids and short-acting b-agonists. She had no symptoms suggestive of any connective tissue disease. She had no family history of respiratory disease. She was a heavy smoker, having accrued a 10-pack-yr history of smoking, but denied any illicit drug use. She was unemployed. There was no history of exposure to hazardous dusts.