A 24-year-old African American woman presents with mild dyspnea on exertion, fever, and a rash on her legs. Her symptoms have come on gradually and she reports no pleuritic chest pain, hemoptysis or sputum production. She has no significant past medical history, smokes 10 cigarettes/day and is not taking any medications. Physical examination reveals generalized lymphadenopathy and tender erythematous nodules on her legs. CXR shows bilateral symmetric hilar adenopathy and reticulonodular changes in both lungs. She has a restrictive lung disease pattern on pulmonary function testing. Which of the following is the most likely diagnosis?
(d) Source: (Kasper, p. 2022) Sarcoidosis is the most likely diagnosis. Granulomatous inflammatory changes of sarcoidosis may occur in almost any organ. About 90% of patients with sarcoid will have an abnormal CXR at some point.
Hodgkin's disease
tuberculosis
rheumatic fever
sarcoidosis
Respiratory