Die Bedeutung der Stadieneinteilung der Sarkoidose (Morbus Boeck)

Wurm, Karl

doi:10.1055/s-0028-1112616

Cited by 21 publications

(5 citation statements)

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“…CXR is the basis of radiological staging, which has some implications for the long-term prognosis. The original staging of sarcoidosis has been developed from lung involvement as determined only by X-ray [7,8] (see Table 3). It must therefore be emphasized that determination of lung involvement by high-resolution computer tomography (HRCT), which is much more sensitive to detect parenchymal involvement, should not be mixed up with this classification, as the long-term prognosis of the disease was derived from the original CXR classification.…”

Section: Imagingmentioning

confidence: 99%

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Diagnosis of Sarcoidosis

Wessendorf

Bonella

Costabel

2015

Clinic Rev Allerg Immunol

100

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The diagnosis of sarcoidosis, a systemic granulomatous disease, is based on a compatible clinical-radiological picture and the histological evidence of noncaseating granulomas. Other diseases mimicking sarcoidosis, mostly infections and other granulomatoses, have to be excluded. There is no single test for sarcoidosis, and the presence of granulomas alone does not establish the diagnosis. Symptoms of sarcoidosis are not specific and can be markedly different according to organ involvement and disease course. Respiratory symptoms and fatigue are the most common symptoms at any stage of disease. Histological confirmation is not needed for Löfgren's or Heerfordt's syndrome and asymptomatic bihilar lymphadenopathy. The radiological staging system is still based on chest radiography, and computed tomography is not mandatory for routine follow-up. (18)F-fluorodeoxyglucose positron emission tomography may be of value in special cases. For assessment of lung involvement and follow-up, pulmonary function tests are necessary with vital capacity being the most important single parameter and diffusion capacity the most sensitive. Bronchoscopy with biopsy is the most common procedure for detection of granulomas, when there is no easier biopsy site like skin or peripheral lymph nodes. Endobronchial ultrasonography-guided transbronchial needle aspiration has replaced mediastinoscopy for evaluation of mediastinal and hilar lymph nodes with a high diagnostic yield. Despite numerous studies, no single biomarker can be reliably used for correct diagnosis or exclusion of sarcoidosis. Genetic testing, despite promising advances, has still not been included in routine care for sarcoidosis patients. The long-term prognosis of sarcoidosis depends on the different organ manifestations: Cardiac or central nervous involvement, together with respiratory complications, is critical. A multidisciplinary approach is necessary for comprehensive care of the sarcoidosis patient.

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Section: Imagingmentioning

confidence: 99%

“…Radiological CXR staging system of sarcoidosis[7,8] Fig. 1 Sarcoidosis IV: In this 64-year-old male, lung function tests were within the normal range: IVC 82 % pred, TLC 89 % pred.…”

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confidence: 99%

Diagnosis of Sarcoidosis

Wessendorf

Bonella

Costabel

2015

Clinic Rev Allerg Immunol

100

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“…The use of chest X-rays and the radiographic staging system for the initial evaluation of patients has been a topic of debate, six decades after its introduction by Wurm [30] and modification by Scadding [31]; the poor sensitivity and impaired inter-observer agreement of chest X-rays serve as significant disadvantages to its use [32]. HRCT scans were seen to show pulmonary involvement in 23% of patients with stage 0 and 30% of patients with stage 1 on chest radiographs in a recent study [33].…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis of 2-Year Follow-Up of Patients with Incidental Findings of Sarcoidosis

Thomas-Orogan,

Barratt,

Zafran

et al. 2024

Diagnostics

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Introduction: Sarcoidosis is a multi-system granulomatous disease most commonly involving the lungs. It may be incidentally diagnosed during imaging studies for other conditions or non-specific symptoms. The appropriate follow-up of incidentally diagnosed asymptomatic stage 1 disease has not been well defined. Objective: To define the clinical course of incidentally diagnosed asymptomatic stage 1 sarcoidosis and propose an algorithm for the follow-up of these patients. Methodology: A retrospective case note analysis was performed of all EBUS-TBNA (endobronchial ultrasound-guided transbronchial needle aspiration)-confirmed cases of stage 1 sarcoidosis presenting incidentally to Bristol and Liverpool Interstitial Lung Disease services. Clinical history, serology results, imaging scans, and lung function parameters were examined at baseline, 12, and 24 months. A cost analysis was performed comparing the cost of the current 2-year follow-up guidance to a 1 year follow-up period. Results: Sixty-seven patients were identified as the final cohort. There was no significant change in the pulmonary function tests over the two-year follow-up period. Radiological disease stability was observed in the majority of patients (58%, n = 29), and disease regression was evidenced in 40% (n = 20) at 1 year. Where imaging was performed at 2 years, the majority (69.8%, n = 37) had radiological evidence of disease regression, and 30.2% (n = 16) showed radiological evidence of stability. All patients remained asymptomatic and did not require therapeutic intervention over the study period. Conclusions: Our results show that asymptomatic patients with incidental findings of thoracic lymph nodal non-caseating granulomas do not progress over a 2-year period. Our results suggest that the prolonged secondary-care follow-up of such patients may not be necessary. We propose that these patients are followed up for 1 year with a further year of patient-initiated follow-up (PIFU) prior to discharge.

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“…Phenotypic classifications aim to predict individual patient outcomes, guide specific therapeutic interventions and assist clinicians in the management of patients, or refer them to experienced centers [13][14][15]. In 1960, Karl Wurm first proposed a phenotypical staging of sarcoidosis [16], and it was modified by Guy Scadding in 1961 [17]. This classification that was based entirely on chest X-ray findings showing involvement of the lungs and hilar lymph nodes.…”

Section: Phenotyping the Diseasementioning

confidence: 99%

Phenotypes and Serum Biomarkers in Sarcoidosis

Della Zoppa,

Bertuccio,

Campo

et al. 2024

Diagnostics

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Sarcoidosis is a multisystem disease, which is diagnosed on a compatible clinical presentation, non-necrotizing granulomatous inflammation in one or more tissue samples, and exclusion of alternative causes of granulomatous disease. Considering its heterogeneity, numerous aspects of the disease remain to be elucidated. In this context, the identification and integration of biomarkers may hold significance in clinical practice, aiding in appropriate selection of patients for targeted clinical trials. This work aims to discuss and analyze how validated biomarkers are currently integrated in disease category definitions. Future studies are mandatory to unravel the diverse contributions of genetics, socioeconomic status, environmental exposures, and other sociodemographic variables to disease severity and phenotypic presentation. Furthermore, the implementation of transcriptomics, multidisciplinary approaches, and consideration of patients’ perspectives, reporting innovative insights, could be pivotal for a better understanding of disease pathogenesis and the optimization of clinical assistance.

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Die Bedeutung der Stadieneinteilung der Sarkoidose (Morbus Boeck)

Cited by 21 publications

References 0 publications

Diagnosis of Sarcoidosis

Diagnosis of Sarcoidosis

A Retrospective Analysis of 2-Year Follow-Up of Patients with Incidental Findings of Sarcoidosis

Phenotypes and Serum Biomarkers in Sarcoidosis

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