Reappraisal of Prevailing Premises in Sarcoidosis
This book advances an evidence-based, unifying conceptual view of sarcoidosis that accounts for many of its baffling and seemingly paradoxical features. It thoroughly explores certain aspects of sarcoidosis—including its fundamental nature, causation, relationship to neoplasia, and appropriate treatment—in which prevailing premises either lack support or are opposed by a critical analysis of available data. Where possible, the text transcends description by positing plausible pathogenetic mechanisms. The final chapter sketches 20 fundamental questions, suitable candidates for future investigation, modeled after Hilbert’s justly famed 1900 address to mathematicians at the Second International Congress.
Jerome M. Reich, MD, FCCP, received his doctoral degree from the State University of New York, College of Medicine at Syracuse, and his post- graduate training from University of Utah-affiliated hospitals. A pulmonologist, he developed an ongoing investigative interest in sarcoidosis supported by the resources and staff of the Center for Health Services Research, Kaiser Permanente NW Region. This support led to the generation of numerous articles over three decades, many of which challenged prevailing views, such as the course and prognosis of sarcoidosis in a non-referral setting. Strongly influenced by the seminal research of Colin Munro, he expanded on the consequences of Munro’s experimental findings, which replaced the concept of sarcoidosis as a systemic granulomatous disease due to unknown causes with its alternative, a syndrome characterized by immunological fallback to a more primitive (granulomatous) response to a variety of agents due to cell-mediated immune inefficiency.
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