2012PubMedRequires access

[Sarcoidosis--diagnostics, prognosis and therapy. A retrospective analysis].

Martina Doubková, Ilona Binková, Jana Skřičková

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Abstract

Sarcoidosis is systematic granulomatous disease of unknown etiology which can affect any organ. Sarcoidosis belongs to diseases called interstitial lung diseases. Our study is a retrospective analysis of 169 patients (100 females and 69 males), whom we diagnosed sarcoidosis at our pulmonary department in years 2005-2010. Aim of the analysis was to find out prognostic factors and to describe the course of disease. Median age of sarcoidosis patients was 48 years (20-79). Females : males ratio was 1.5 : 1. Non smoker : smoker (or former smoker) ratio was 2.2 : 1. Familial occurrence was observed in 4 patients (2.4%). At diagnosis, stage 0 was present in 6 (3.5%) patients, stage I in 58 (34%) patients, stage II in 84 (49.5%) patients, stage III in 18 (11%) patients, and stage IV in 3 (2%) patients. Diagnosis was confirmed by histology in 111 patients. In 76 patients there was extrapulmonary sarcoidosis. The coincidence of sarcoidosis with autoimmune diseases was observed in 10 patients; 6 patients developed trombembolic disease. One patient suffered from sarcoidosis with cystic fibrosis. Spontaneous resolution was seen in 65 (38.5%) patients; 37 (64%) stage I patients, 26 (31%) stage II patients, and 2 (11%) stage III patients. One hundred one patients (60%) received corticosteroids. Adverse events of corticosteroid therapy were observed in 28 (26%) patients. In sarcoidosis patients with spontaneous resolution, no relapse of disease was observed. On the other hand, eleven (11%) patients treated with glucocorticosteroids relapsed. Median time to sarcoidosis relapse was 6 months (2-34). The age under 40 years, the X-ray stage I or II, the high CD4/CD8 ratio in bronchoalveolar fluid, pulmonary involvement, and therapy need for a period shorter than 2 years were assessed as a significant good prognostic factors. Observed lethality of our patient cohort was 1.2% (2 patients; both deaths related to sarcoidosis).

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What this paper is about

Sarcoidosis is systematic granulomatous disease of unknown etiology which can affect any organ. Sarcoidosis belongs to diseases called interstitial lung diseases. Our study is a retrospective analysis of 169 patients (100 females and 69 males), whom we diagnosed sarcoidosis at our pulmonary department in years 2005-2010. Aim of the analysis was to find out prognostic factors and to describe the course of disease. Median age of sarcoidosis patients was 48 years (20-79). Females : males ratio was 1.5 : 1. Non smoker : smoker (or former smoker) ratio was 2.2 : 1. Familial occurrence was observed in 4 patients (2.4%). At diagnosis, stage 0 was present in 6 (3.5%) patients, stage I in 58 (34%) patients, stage II in 84 (49.5%) patients, stage III in 18 (11%) patients, and stage IV in 3 (2%) patients. Diagnosis was confirmed by histology in 111 patients. In 76 patients there was extrapulmonary sarcoidosis. The coincidence of sarcoidosis with autoimmune diseases was observed in 10 patients; 6 patients developed trombembolic disease. One patient suffered from sarcoidosis with cystic fibrosis. Spontaneous resolution was seen in 65 (38.5%) patients; 37 (64%) stage I patients, 26 (31%) stage II patients, and 2 (11%) stage III patients. One hundred one patients (60%) received corticosteroids. Adverse events of corticosteroid therapy were observed in 28 (26%) patients. In sarcoidosis patients with spontaneous resolution, no relapse of disease was observed. On the other hand, eleven (11%) patients treated with glucocorticosteroids relapsed. Median time to sarcoidosis relapse was 6 months (2-34). The age under 40 years, the X-ray stage I or II, the high CD4/CD8 ratio in bronchoalveolar fluid, pulmonary involvement, and therapy need for a period shorter than 2 years were assessed as a significant good prognostic factors. Observed lethality of our patient cohort was 1.2% (2 patients; both deaths related to sarcoidosis).

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Available abstract

Sarcoidosis is systematic granulomatous disease of unknown etiology which can affect any organ. Sarcoidosis belongs to diseases called interstitial lung diseases. Our study is a retrospective analysis of 169 patients (100 females and 69 males), whom we diagnosed sarcoidosis at our pulmonary department in years 2005-2010. Aim of the analysis was to find out prognostic factors and to describe the course of disease. Median age of sarcoidosis patients was 48 years (20-79). Females : males ratio was 1.5 : 1. Non smoker : smoker (or former smoker) ratio was 2.2 : 1. Familial occurrence was observed in 4 patients (2.4%). At diagnosis, stage 0 was present in 6 (3.5%) patients, stage I in 58 (34%) patients, stage II in 84 (49.5%) patients, stage III in 18 (11%) patients, and stage IV in 3 (2%) patients. Diagnosis was confirmed by histology in 111 patients. In 76 patients there was extrapulmonary sarcoidosis. The coincidence of sarcoidosis with autoimmune diseases was observed in 10 patients; 6 patients developed trombembolic disease. One patient suffered from sarcoidosis with cystic fibrosis. Spontaneous resolution was seen in 65 (38.5%) patients; 37 (64%) stage I patients, 26 (31%) stage II patients, and 2 (11%) stage III patients. One hundred one patients (60%) received corticosteroids. Adverse events of corticosteroid therapy were observed in 28 (26%) patients. In sarcoidosis patients with spontaneous resolution, no relapse of disease was observed. On the other hand, eleven (11%) patients treated with glucocorticosteroids relapsed. Median time to sarcoidosis relapse was 6 months (2-34). The age under 40 years, the X-ray stage I or II, the high CD4/CD8 ratio in bronchoalveolar fluid, pulmonary involvement, and therapy need for a period shorter than 2 years were assessed as a significant good prognostic factors. Observed lethality of our patient cohort was 1.2% (2 patients; both deaths related to sarcoidosis).

Key concepts: Sarcoidosis, Medicine, Stage (stratigraphy), Etiology, Retrospective cohort study, Internal medicine, Systemic disease, Disease

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