Abstract
The aim of this work was to verify the correlations between different pulmonary morphological patterns and functional outcomes in sarcoidosis patients, using a validated score for the comparison between the high-resolution computed tomography (HRCT) of patients belonging to different imaging patterns. From the electronic database of the reference center for interstitial lung diseases of our University Hospital, we retrospectively selected 55 patients with a diagnosis of sarcoidosis according to the American Thoracic Society (ATS) criteria; we evaluated the initial HRCT examination and pulmonary function tests collected at baseline and after a year. Patients were divided into typical (48% of patients) and atypical (52%) HRCT patterns, and a computer tomography activity score (CTAS) was associated with each HRCT appearance detected; clinical history, impact of therapy, and extra-thoracic locations were also considered. We found that worsening of diffusing capacity for carbon monoxide (DLCO) is related to the CTAS (r = −0.20, p = 0.01), and there was an inverse correlation between the variation of forced vital capacity (FVC) and the value of the CTAS (r = −0.30, p = 0.23) in the subgroup of patients with atypical patterns. CTAS were higher in patients with extra-pulmonary localizations (p = 0.05) and the subgroup of patients with extra-thoracic locations and atypical manifestations had a greater worsening in terms of variation of FVC (p = 0.03) and DLCO% (p = 0.04). No difference between treated and untreated patients was found.
Highlights
IntroductionSarcoidosis is a systemic granulomatous pathology of unknown etiology, first described in 1899 by Boeck who found “epithelioid cells with a pale nucleus and some giant cells” in a benign skin lesion [1]
The following eligibility criteria were adopted: patients with pulmonary sarcoidosis diagnosed according to the American Thoracic Society / European Respiratory Society / World Association for Sarcoidosis and Other Granulomatous Disorders (ATS/ERS/WASOG) criteria [4], the availability of a complete clinical history, at last one-year clinical follow up, at least two high-resolution computed tomography (HRCT) scans during an active phase of the disease, at least two complete pulmonary function test (PFT), and a six-minute walking test (6MWT)
We critically reviewed the clinical history of 145 patients followed by the referral center for the diagnosis of sarcoidosis
Summary
Sarcoidosis is a systemic granulomatous pathology of unknown etiology, first described in 1899 by Boeck who found “epithelioid cells with a pale nucleus and some giant cells” in a benign skin lesion [1] This disease is not considered rare among interstitial lung diseases (ILD), and some important epidemiological variations have been reported related to geographical and ethnic factors. The maximum incidence is registered in the northern European countries European (up toin40the cases per 100,000 inhabitants), inhabitants), whereas the minimal incidence has countries been reported Eastern. Japan) [2]; it appears to be more common in African Americans than Whites [3].
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