PRIMARY-CARE PARADIGM FOR MANAGEMENT OF SARCOIDOSIS .1.

Sarcoidosis is a systemic granulomatous disease of undetermined etiolo gy in which the immune system is overstimulated. Management of the pat ient with sorcoidosis entails continuity of patient care far beyond di sease, even into remission. Care is comprehensive, including all invol ved organ systems, coordination of specialty consultations and service s, and diagnostic tests. Therapeutic decisions are the responsibility- of the primary care practitioner. Prognosis of sarcoidosis is not unif ormly good. Patients can die. Subacute sarcoidosis patients usually do not require pharmacologic therapy. Chronic sarcoidosis may require lo ng-term treatment For years to indefinitely. Corticosteroids are still the drugs of choice and other therapy is now available. Health organi zations and private nonprofit support groups are available for patient education and assistance. Close support must still come from the fami ly unit. Sarcoidosis may occur in Family members in different cohorts at all ages in life and in any racial or ethnic group. This article is the first in a two-part series on management of the patient with sarc oidosis in the 21st century by the primary are provider. Applications of principles of family medicine are emphasized. Part 1 considers cont inuity, comprehensiveness, and coordination of care. Part 2 will compl ete coordination of core, and consider community, prevention, and fami ly aspects of this disease.