Role of serum markers in diagnosis of exacerbations of sarcoidosis

Abstract

In order to improve the diagnosis of exacerbation and activity of sarcoidosis in patients receiving complex treatment, including corticosteroids, 303 patients with respiratory sarcoidosis were examined at the initial visit (before treatment) and every 2 months of treatment for 2 years. Group 1–193 patients without exacerbation of sarcoidosis; group 2–51 patients with exacerbation of sarcoidosis, who did not take corticosteroids (GCS); group 3–59 patients with exacerbation of sarcoidosis, long-term taking corticosteroids. In order to improve the diagnosis of exacerbation and activity of sarcoidosis in patients receiving complex treatment, including glucocorticosteroids, 303 patients with respiratory sarcoidosis were examined at the initial visit (before treatment) and every 2 months of treatment for 2 years. Group 1–193 patients without exacerbation; group 2–51 patients with exacerbation who did not take corticosteroids (GCS); group 3–59 patients with exacerbation, long-term taking corticosteroids. Conducted clinical and biochemical blood tests, computed tomography of the respiratory organs, spirography, echocardiography, electrocardiography at rest. Changes in the following serum markers were studied: free radicals (RwR), resistance to oxidative stress calculated by trolox equivalent (UcE), angiotensin-converting enzyme (ACE), adenosine deaminase (ADA), the correlation coefficient (CC) was calculated according to the developed formula (patent): CC = ACE/ADA in arbitrary units (KKnorm = 1.2–2.4), markers of lipid metabolism disorders were determined, to assess the activity of endogenous inflammation, the indicator of lipoidosis activity (PAL) was calculated according to the previously developed formula (patent): PAL = TC/LDLxc + TGL. Before treatment, 100 % of patients with sarcoidosis showed signs of moderate endogenous inflammation, an active granulomatous process, hypoxemia, and a decrease in the body’s antioxidant defense. The sensitivity of the serum adenosine deaminase (ADA) enzyme in exacerbations of sarcoidosis was 31 %, and the specificity was 48 %. The correlation coefficient (CC) had a sensitivity of 85.0 %; specificity 78.8 %; diagnostic efficiency of 80.0 % and higher clinical value than ACE, ADA, PAL, SVR, UKO. Thus, the serum enzyme adenosine deaminase (ADA) should be included in the mandatory minimum of laboratory methods in patients with sarcoidosis.