Background: With its high impact on quality of life, fatigue represents a frequently misdiagnosed manifestation of sarcoidosis, often persisting despite the absence of disease activity. In addition, standard treatment for sarcoidosis has limited efficacy on fatigue.
 
Aim: to explore any predictors of fatigue in patients with sarcoidosis.
 
Methods: in this monocentric study, 82 patients with sarcoidosis were enrolled from 2019 to 2023. For each patient, we retrospectively collected clinical, functional, and radiological data. Moreover, at the most recent follow-up visit, every patient completed three questionnaires: the FAS (fatigue assessment scale), the SFNL (small fiber neuropathy screening lists), and the St. George questionnaire.
 
Results: 24/82 patients had a FAS score ?22 (FS), while 58 had a FAS score <22. The two groups were similar with regard to age at diagnosis (50 vs. 49 years; p=0.633) and sarcoidosis treatment (first line: 67% vs. 55%; p=0.336; second line: 37.5% vs. 24%; p=0.281). However, female gender and fatigue at diagnosis were more prevalent in the FS group (58% vs. 35%; p=0.046 and 37% vs. 14%; p=0.016, respectively). St. George questionnaire and SFNL scores were higher in the FS group at the most recent follow-up [48.8 (0 - 77.4) vs. 9.48 (0 - 47.9), p=<0.0001; and 23 (0 - 51) vs. 6 (0 - 34); p=<0.0001].
 
Conclusion: Fatigue significantly affects the quality of life of patients with sarcoidosis. Patients with a FAS score ?22 are more frequently female and complain of fatigue from the beginning of their disease, regardless of the type of treatment and disease extent.