A 60-year-old man with newly diagnosed pulmonary sarcoidosis (stage II) has progressive dyspnea over 6 months despite observation. Pulmonary function tests show declining FVC from 75% to 55% predicted and DLCO from 65% to 40% predicted. What is the recommended first-line treatment?
- A Methotrexate
- B Prednisone ✓
- C Infliximab
- D Azathioprine
Correct answer: B. Prednisone
Explanation
Progressive pulmonary sarcoidosis with worsening symptoms and declining lung function is an indication for systemic corticosteroids. Prednisone (typically 20-40 mg/day) is first-line. Steroid-sparing agents like methotrexate are used for refractory cases or when corticosteroids are contraindicated. Infliximab is third-line.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.