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©2013 UpToDate ® Print Email ACCESS study criteria for organ involvement in patients with biopsy-confirmed sarcoidosis - II Organ Definite Probable Nonthoracic lymph node 1. New palpable node above waist 2. Lymph node >2 cm by computed tomographic (CT) scan Parotid/salivary glands 1. Symmetrical parotitis with syndrome of mumps 2. Positive gallium scan ("Panda sign") Renal 1. Treatment responsive renal failure 1. Steroid responsive renal failure in patient with diabetes and/or hypertension Liver 1. Liver function tests > three times normal 1. Compatible computed tomographic (CT) scan 2. Elevated alkaline phosphatase Spleen 1. Enlargement by: Exam Computed tomographic (CT) scan Radioisotope scan Bone marrow 1. Unexplained anemia 2. Leukopenia 3. Thrombocytopenia Bone/joints 1. Cystic changes on hand or feet phalanges 1. Asymmetric painful clubbing Ears/Nose/Throat 1. Unexplained hoarseness with exam consistent with granulomatous involvement Muscles 1. Increased creatine phosphokinase (CK) aldolase which decreases with treatment 1. Increased creatine, phosphokinase (CK)/aldolase Reproduced with permission from: Judson, MA, RP Baughman, AS. Teirstein, ML Terrin, and H Yeager, Jr. 1999. Defining organ involvement in sarcoidosis: the ACCESS proposed instrument. ACCESS Research Group. A Case Control Etiologic Study of Sarcoidosis. Sarcoidosis, Vasculitis, and Diffuse Lung Diseases 16:75-86. Copyright © 1999 Sarcoidosis, Vasculitis, and Diffuse Lung Diseases.