SARCOIDOSIS WITH SINO-NASAL INVOLVEMENT: A RETROSPECTIVE ANALYSIS OF 112 CASES

Abstract

SESSION TITLE: Wednesday Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/23/2019 09:45 AM - 10:45 AM PURPOSE: Extrapulmonary involvement has been found in about 30–40% of patients suffering from sarcoidosis. The frequency of sino-nasal involvement in sarcoidosis is reported to be quite low and yet to be defined. METHODS: We retrospectively analyzed 112 diagnosed cases of pulmonary sarcoidosis for nasal symptoms. The patients were identified from the patients visiting the Outpatient Clinic of Vallabhbhai Patel Chest Institute, Delhi, India, a tertiary care hospital for respiratory medicine from May 2017 to Feb 2019 RESULTS: Pulmonary sarcoidosis of the patients was staged as stage I (n = 21), stage II (n = 73) and stage III (n = 18) on chest radiographs. All patients received systemic corticosteroid treatment and most patients received topical steroids. 29 patients (25.9%) denied any nasal symptoms. 40 patients (35.7%) had intermittent symptoms that lasted less than three weeks, 7 of which required intervention with nasal steroids or normal saline. 43 patients (38.4%) were treated with nasal steroids and antibiotics for symptoms that lasted more than three weeks. 25 patients (22.3%) had the resolution of their symptoms after treatment with nasal steroids and antibiotics. 18 patients (16.2%) had symptoms that were unresponsive to three weeks of oral antibiotics and nasal steroids. Out of 83 with nasal symptoms, Absolute Eosinophil Count was raised in 18 cases (AEC>350). Serum IgE was found to be raised in 23 cases, 15 of which has IgE in the range of 300-1000 IU/ml while rest of the 8 cases had Se IgE more than 1000 IU/ml. The most frequent signs and symptoms were Rhinitis and Post-nasal drip (74), nasal polyps (1 case), epistaxis (3 cases), nasal crusts (3 cases) and anosmia (2 cases). Majority of the patients had only postnasal drip (56 cases). CONCLUSIONS: Our study suggests that sarcoidosis may be associated with a much higher incidence of sinonasal involvement. Further data needs to be collected in a larger population. CLINICAL IMPLICATIONS: Sino-nasal symptoms in sarcoidosis should be regularly screened, which may be atopic or non-atopic. The non-atopic cases need to be assessed by nasal biopsy if not responding to topical steroids. Further studies need to be done in larger populations for sino-nasal involvement in sarcoidosis. DISCLOSURES: no disclosure on file for Balakrishnan Menon; No relevant relationships by Mani Tiwari, source=Web Response