Airways Obstruction in Patients with Sarcoidosis

Bartz, Raquel R.; Stern, Eric J.

doi:10.1097/00005382-200010000-00009

Cited by 43 publications

(20 citation statements)

References 18 publications

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“…In such cases, PFT reveal disturbances of lung volume restriction character occurring with the same frequency as airflow limitation. In patients with pulmonary sarcoidosis, air trapping is evidenced by high-resolution computed tomography [2, 3]. Airway obstruction may result from the narrowing of the bronchial wall due to granulomatous lesions, compressive enlarged lymph node, or airway distortion attributable to pulmonary fibrosis.…”

Section: Introductionmentioning

confidence: 99%

The Yield of Endobronchial Biopsy in Pulmonary Sarcoidosis: Connection between Spirometric Impairment and Lymphocyte Subpopulations in Bronchoalveolar Lavage Fluid

Kieszko¹,

Krawczyk²,

Michnar³

et al. 2004

Respiration

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Background: Sarcoidosis is a multi-organ granulomatous disorder of undetermined aetiology with 90% of patients exhibiting some degree of pulmonary involvement. Transbronchial biopsy and endobronchial biopsy (EBB) with a fiber-optic bronchoscope, which demonstrate giant or epithelial cells of granuloma formation, have been established as standard methods for histological confirmation of sarcoidosis. Objectives: The analysis of EBB and bronchoalveolar lavage (BAL) specimens was used to assess the frequency of positive EBB findings in patients with pulmonary sarcoidosis. The influence of spirometric abnormalities and BAL findings on EBB-based diagnosis was also evaluated. Methods: The examined group of patients comprised 60 subjects mean age 39.4 ± 9.65 years). The results of pulmonary function tests, EBB and BAL were analysed. Results: EBB was performed on 52 patients. Positive histological results were found in 40% of subjects; 12 of them were affected by spirometry impairment. All patients with restriction and almost half of the subjects with obstruction disorders had positive EBB findings. In the BAL fluid, the percentage of CD3+ and CD4+ cells was significantly lower and the percentage of CD19+ and CD8+ lymphocytes was significantly higher in patients with positive biopsies in comparison with the subjects with negative EBB findings. Conclusions: Positive biopsies are related to the intensity of abnormalities in the pulmonary function tests and BAL, and may reflect an advanced stage of sarcoidosis.

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Section: Introductionmentioning

confidence: 99%

The Yield of Endobronchial Biopsy in Pulmonary Sarcoidosis: Connection between Spirometric Impairment and Lymphocyte Subpopulations in Bronchoalveolar Lavage Fluid

Kieszko¹,

Krawczyk²,

Michnar³

et al. 2004

Respiration

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“…Additionally, the extent of the interstitial changes in HRCT was well correlated with respiratory functional impairment [19], while other several studies have reported that HRCT features of air trapping correlated well with obstruction indices in PFTs [22][23][24][25]. The nature of the interstitial and airway involvement in sarcoidosis could explain the discrepancies reported in the fore-mentioned studies [21][22][23][24][25].…”

Section: Discussionmentioning

confidence: 95%

Clearance of technetium-99m-DTPA in pulmonary sarcoidosis

Αντωνίου

Tzanakis

Malagari

et al. 2016

Monaldi Arch Chest Dis

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Background. The aim of this study was to explore the possible association of the lung clearance of 99mTc- DTPA scan with HRCT lung abnormalities and with the pulmonary function tests [PFTs] in patients with sarcoidosis. Methods. We studied prospectively 15 patients [5 males, 10 females] of median age 46yr [range 27-67] with histologically proved sarcoidosis. HRCT scoring included the sum of the severity and extent of lymph node enlargement and parenchymal involvement. Results. The mean DTPA clearance half-time [τ 1/2 <40 min] was found [mean [SD]] 38.3+4.5min. The lymph node enlargement was found 34% and the parenchymal involvement 12%. DTPA clearance was negatively correlated with the parenchymal involvement [r= -0.651, p=0.009]. The HRCT parenchymal abnormalities were found significantly correlated with PFTs [FVC [r= -0.65, p=0.008] and TLCO [r= -0.76, p=0.02]. Conclusions. Our data suggest a moderate association between 99mTc-DTPA scan and HRCT in pulmonary sarcoidosis. However, further studies in large scale of sarcoid patients are needed to clarify the role of this novel methodology in the evaluation and follow-up of this disorder.

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“…Third, small airway disease was not evaluated in this study. In patients with sarcoidosis, it was reported that expiratory CT was useful to evaluate small airway disease, which was detected as low attenuation area [23, 24]. The analysis of lung density or airway dimension with expiratory CT may provide further information regarding airway lesions in sarcoidosis.…”

Section: Discussionmentioning

confidence: 99%

Computed Tomography Analysis of Airway Dimensions and Lung Density in Patients with Sarcoidosis

Handa

Nagai²,

Hirai³

et al. 2008

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Background: It was previously reported that visual scores of the lung opacities were associated with lung function in patients with sarcoidosis. However, there are no reports on the evaluation of airway dimensions or lung density by computed tomography (CT) in sarcoidosis patients. Objectives: The aim of this study was to investigate whether airway dimensions and lung densities assessed by CT associate with pulmonary function in patients with sarcoidosis. Methods: CT scanning was performed in 43 sarcoidosis patients and lung densities were measured using in-house software. Means and standard deviations of lung density, kurtosis and skewness of lung density histograms were calculated. Tracheal area and airway wall area/total airway area (WA%) of the right apical bronchus were also measured. Pulmonary function tests were performed on the same day. Results: Increased standard deviation of lung density and decreased kurtosis and skewness of lung density histograms were all associated with decreased total lung capacity, vital capacity and diffusion capacity. Increased standard deviation of lung density was also associated with decreased percentages of forced expiratory volume in 1 s and peak expiratory flow (%PEF). There was a positive correlation between tracheal area corrected by body surface area and %PEF, and negative correlation between WA% and %PEF. Stepwise regression analysis showed that increased standard deviation of lung density and decreased tracheal area were independently associated with lower %PEF. Conclusions: Thus, in sarcoidosis, densitometric parameters reflect restrictive lung function impairment. In addition to parenchymal lesions, it is concluded that the luminal area of the central airways also affects PEF.

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Airways Obstruction in Patients with Sarcoidosis

Cited by 43 publications

References 18 publications

The Yield of Endobronchial Biopsy in Pulmonary Sarcoidosis: Connection between Spirometric Impairment and Lymphocyte Subpopulations in Bronchoalveolar Lavage Fluid

The Yield of Endobronchial Biopsy in Pulmonary Sarcoidosis: Connection between Spirometric Impairment and Lymphocyte Subpopulations in Bronchoalveolar Lavage Fluid

Clearance of technetium-99m-DTPA in pulmonary sarcoidosis

Computed Tomography Analysis of Airway Dimensions and Lung Density in Patients with Sarcoidosis

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