Dynamics of clinical, X-ray and functional data during treatment of patients with sarcoidosis

Abstract

To analyze the literature data and the results of original studies on the respiratory function in patients with sarcoidosis. The study included 1199 patients with sarcoidosis (67.8% women and 32.2% of males, median age 43 years). The first X-ray stage was documented in 34.8% of patients , stage II in 57.0%, stage III in 6.1%, stage IV in 1.3%, stage 0 in 0.7%. One patient (0.1%) had pleural sarcoidosis. Loefgren syndrome was diagnosed in 20% of the patients. In 658 patients (54.9%) the diagnosis was confirmed by biopsy studies. The patients with sarcoidosis exhibited significant correlation between radiographic and spirometric characteristics. In those with Loefgren syndrome, all breathing parameters were much better than in the remaining ones. Changes of spirometry parameters were more pronounced in smokers and in patients with concomitant lung diseases. However, the lung function remained impaired after adjustment for these factors, and 9,7% of the cases positively responded to the administration of a short-acting bronchodilator. Х-ray examination and spirometry are independent methods for the evaluation of the health status of patients with sarcoidosis and their results do not always correlate with each other after different treatment regimens. Changes in Х-ray image and lung vital capacity were consistent in patients treated with prednisone, methotrexate and pentoxifylline, but not in the cases treated with vitamin E and in the absence of treatment. Spirometry with simultaneous X-ray examination is recommended for all patients with intrathoracic sarcoidosis. Forced vital capacity of lungs (FVC) is an independent criterion for evaluating the condition of patients with sarcoidosis and the effectiveness of the treatment.