Imaging of sarcoidosis of the airways and lung parenchyma and correlation with lung function

Nunès, Hilario; Uzunhan, Y.; Gille, Thomas; Lamberto, Christine; Valeyre, Dominique; Brillet, Pierre-Yves

doi:10.1183/09031936.00025212

Cited by 140 publications

(103 citation statements)

References 111 publications

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“…PH is a rare complication of another lung granulomatous disease, sarcoidosis [75][76][77]. Although this complication is rare in absolute terms, it is not uncommon in patients with advanced disease, particularly in patients with stage III and IV disease [4].…”

Section: Other Ilds Associated With Phmentioning

confidence: 99%

Pulmonary hypertension in chronic interstitial lung diseases

Caminati¹,

Cassandro²,

Harari³

2013

European Respiratory Review

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Pulmonary hypertension (PH) is a common complication of interstitial lung diseases (ILDs), particularly in idiopathic pulmonary fibrosis and ILD associated with connective tissue disease. However, other lung diseases, such as combined pulmonary fibrosis and emphysema syndrome, pulmonary Langerhans cell histiocytosis, and lymphangioleiomyomatosis, may also include PH in their clinical manifestations. In all of these diseases, PH is associated with reduced exercise capacity and poor prognosis. The degree of PH in ILDs is typically mild-to-moderate. However, some of these patients may develop a disproportionate increase in PH that cannot be justified solely by hypoxia and parenchymal injury: this condition has been termed “out-of-proportion” PH. The pathogenesis of PH in these diseases is various, incompletely understood and may be multifactorial. The clinical suspicion (i.e. increased dyspnoea, low diffusion capacity) and echocardiographic assessment are the first steps towards proper diagnosis of PH; however, right heart catheterisation remains the current gold standard for diagnosis of PH. At present, no specific therapies have been approved for the treatment of PH in patients with ILDs

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Section: Other Ilds Associated With Phmentioning

confidence: 99%

Pulmonary hypertension in chronic interstitial lung diseases

Caminati¹,

Cassandro²,

Harari³

2013

European Respiratory Review

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“…The function of external respiration was also studied by spirometry body plethysmography, evaluation of lung diffusivity [19,20]. Leflunomide was administered at a dose of 20 mg per day, daily for 3 months.…”

Section: Methodsmentioning

confidence: 99%

Efficiency and Safety of Leflunomide Treatment in Patients With Pulmonary Sarcoidosis

Gavrysiuk¹,

Merenkova²,

Гуменюк

2018

EUREKA: Health Sciences

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Patients who have contraindications to the prescription of GCs (glucocorticosteroids), or have developed serious side effects during treatment with GCs, as well as patients with resistance to GCs therapy, are prescribed immunosuppressants. The aim of the research - to study the efficacy of leflunomide monotherapy in patients with pulmonary sarcoidosis with contraindications to prescription or serious side effects of glucocorticosteroids. Fourteen patients with sarcoidosis of the respiratory system of stage II were examined – 12 women and 2 men aged 30 to 69 years. In 10 patients there were contraindications to the appointment of GCs (diabetes mellitus – 5, hypertension – 3, obesity – 1, exacerbation of gastric ulcer – 1), which caused the appointment of immunosuppressive therapy as a starting. In 4 cases, serious side effects of SCs were noted, requiring the drug to be abolished (osteoporosis – 3, steroid diabetes – 1). Leflunomide was administered at a dose of 20 mg per day, daily for 3 months. The evaluation of efficacy was carried out using computed tomography of the thoracic cavity organs, body plethysmography, spirometry and determination of the diffusivity of the lungs. Monotherapy with leflunomide in patients with contraindications to prescription or serious side effects of GCs was successful in 7 out of 13 patients, in 2 patients there was a stabilization of the process, in 4 patients with leflunomide therapy progression of the disease was noted and in 1 case the treatment was discontinued due to serious side effects of preparation. The results obtained make it possible to recommend the use of leflunomide as monotherapy in patients with pulmonary sarcoidosis with contraindications to the prescription and/or poor tolerability of GCs and methotrexate. It is necessary to continue studying the possibilities of combined use of leflunomide with other drugs of the first line.

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“…Although the condition either regresses or remains stable in most patients, it can progress to pulmonary fibrosis in approximately one-quarter of patients. Spontaneous resolution occurs in 60-90% of patients with stage I disease, and 40-70% of those with stage II (5). That is to say, the frequency of variations in the course of sarcoidosis in stages I, II and III are very high and additional prognostic indictors are needed.…”

Section: Introductionmentioning

confidence: 99%

“…Recently, the correlation between disease severity in CT, functional impairment and radiographic stages of sarcoidosis, as well as pulmonary function tests (PFT) and bronchoalveolar lavage fluid (BALF) cells, have been discussed in the literature (5,(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). However, few systematic evaluations exist exploring the relationships between the various HRCT findings (e.g., micronodules, macronodules, irregular linear opacities, interlobular septal thickening, fibrotic changes, etc.…”

Section: Introductionmentioning

confidence: 99%

Relationship between radiologic patterns, pulmonary function values and bronchoalveolar lavage fluid cells in newly diagnosed sarcoidosis

Aleksonienė¹,

Zeleckienė²,

Matačiūnas³

et al. 2017

J. Thorac. Dis.

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Background: The aim of the present study was to identify specious radiologic and/or physiologic prognostic marker(s), which lead to optimize of the patient follow-up frequency. Methods: Eighty consecutive patients with newly diagnosed pulmonary sarcoidosis. Patients underwent chest radiography, high-resolution computed tomography (HRCT) examination, pulmonary function tests (PFT), bronchoscopy with bronchoalveolar lavage (BAL) and lung biopsy, and bronchoalveolar lavage fluid (BALF) cell examination. Results: The reduction in PFT values seen in radiological sarcoidosis stage III was greater than that seen in stages I and II. The percentage of neutrophils in the lungs was found to increase in stages II and III. PFT indices were correlated negatively with the consolidation and ground glass opacities CT scores, but not with the micronodule or macronodule scores. The rise in the percentage of BALF lymphocytes was associated with the restriction pattern of PFT. The diagnostic value of BALF for sarcoidosis was higher when the typical radiologic patterns of stage I disease were found and that smoking decreased the diagnostic value of CD4/CD8 ratio. Conclusions: This study supports the opinion that the staging of the pulmonary sarcoidosis with chest X-rays is still valuable from the prognostic point of view, because significant correlations between the radiologic stages of sarcoidosis and PFT parameters were found. Chest HRCT was significantly superior to chest X-ray in detecting mediastinal and pulmonary parenchymal changes. However, the prognostic role of HRCT needs to be better investigated evaluating serial examinations. Only consolidation and ground glass scores (neither of which are frequently found in sarcoidosis) hold prognostic value, since these were negatively correlated with PFT parameters.

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Imaging of sarcoidosis of the airways and lung parenchyma and correlation with lung function

Cited by 140 publications

References 111 publications

Pulmonary hypertension in chronic interstitial lung diseases

Pulmonary hypertension in chronic interstitial lung diseases

Efficiency and Safety of Leflunomide Treatment in Patients With Pulmonary Sarcoidosis

Relationship between radiologic patterns, pulmonary function values and bronchoalveolar lavage fluid cells in newly diagnosed sarcoidosis

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