Sarcoidosis - Diagnostics, prognosis and therapy in everyday pneumological practice. A retrospective analysis

Background: Currently, prognostic factors, or therapy in sarcoidosis are frequently discussed, however, up-to-date data concerning the incidence and the management of sarcoidosis in everyday pneumological practice are still missing. Therefore, we decided to analyze the characteristic of comprehensive cohort of sarcoidosis patients. Methods: We retrospectively analyzed all 169 patients, whom the diagnosis of sarcoidosis was set at our pulmonary department in years 2005-2010. Results: Median age of sarcoidosis patients was 48 years (20-79). Females:males ratio was 1.5:1. Non smoker:smoker ratio was 2.2:1. Familial occurrence was observed in 4 patients. At diagnosis, stage 0 was present in 3.5% patients, stage I in 34% patients, stage II in 49.5% patients, stage III in 11% patients, and stage IV in 2% patients. In 76 patients there was extrapulmonary sarcoidosis. The coincidence of sarcoidosis with other autoimune diseases was observed in 10 patients; 6 patients developed trombembolic disease. Spontaneous resolution was seen in 36% patients; 57% of stage I, 29% of stage II, and 11 % of stage III. 64% received corticosteroids. 16% of patients developed chronic sarcoidosis. In sarcoidosis patients with spontaneous resolution, no relapse of disease was observed. On the other hand, 10% of treated patients relapsed. Median time to sarcoidosis relapse was 6 months. There was no difference in age between good and poor risk groups of patients. Observed lethality was 1.2% (2 patients). Conclusion: Male gender, X-ray stage I or II, lymphocytic alveolitis in bronchoalveolar fluid, spontaneous regression, and active disease duration up to 2 years appear to be good prognostic factors.