Management strategies for pulmonary sarcoidosis

Coker, Robina

doi:10.2147/tcrm.s4511

Cited by 13 publications

(9 citation statements)

References 38 publications

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“…Many studies showed that the side effects of steroids, such as weight gain, thickening of the skin, sleep disturbances, osteoporosis and neuropsychiatric disorders, could occur even at low doses and especially with long-term use, steroid therapy was also a significant risk factor for infection and steroid-related diabetes [30,31]. A specific guideline that will allow to monitor the side effects of the steroids for the patients with sarcoidosis is lacking.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Evaluation of 100 Patients with Sarcoidosis in Gazi University, Turkey

Aykan¹,

Türktaş²,

Köktürk³

et al. 2014

Tur Toraks Der

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This study aimed to evaluate the diagnosis, treatment and clinical monitoring of the patients with sarcoidosis and to determine their general characteristics. MATERIAL AND METHODS: We retrospectively examined demographic, clinical, laboratory and radiological findings of 100 patients who were followed-up with the diagnosis of sarcoidosis in Gazi University of Faculty of Medicine, Department of Chest Disease between 1994 and 2010. RESULTS: Mean age of the patients was 44±12 years (22-82), female/male ratio was 2.8 and no difference of the age at diagnosis was found between the genders. Most commonly seen complaints included dyspnea, cough and skin disorders. It was reported that 50% of the men and 17% of the women had a history of smoking and that smokers were presented at advanced stages (Stage 2-3) (p=0.006). Three percent of our patients had familial sarcoidosis. It was seen that 96% of the patients had pulmonary tomography at the time of diagnosis. No correlation was detected between angiotensin-converting enzyme (ACE), erythrocyte sedimentation rate and serum and urine calcium levels and the disease stage. Of the patients, 34% showed impaired respiratory function test (RFT) results and 49% showed decreased diffusing capacity of carbon monoxide (DLCO) values, most commonly with restrictive pattern, at the time of diagnosis. Forced expiratory volume in 1 second (FEV 1), forced vital capacity (FVC) and decreased DLCO values did not show a correlation with the stage of the disease (p<0.01). Of our patients, 16% were diagnosed with sarcoidosis based on clinical, laboratory and radiological findings, whereas other patients underwent some invasive interventions for tissue diagnosis. Most commonly used invasive methods included transbronchial biopsy (34%), punch biopsy (31%), mediastinoscopic or transbronchial mediastinal lymph node biopsy (22% and 9%, respectively). During the follow-up period, 43% of the patients received treatment. During the follow-up, 18 patients (18%) showed relapse in the period after the diagnosis. It was seen that relapse was more common in the patients with advanced stage, who have received treatment at the time of diagnosis (p<0.01 and p=0.04). CONCLUSION: Sarcoidosis is a multisystemic disease that may have a course with several clinical findings and that should be absolutely considered in the differential diagnosis with its commonly or rarely observed findings.

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Section: Discussionmentioning

confidence: 99%

Retrospective Evaluation of 100 Patients with Sarcoidosis in Gazi University, Turkey

Aykan¹,

Türktaş²,

Köktürk³

et al. 2014

Tur Toraks Der

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“…Patients manifest various clinical courses depending on the disease stage and the systems involved. The symptoms are met less frequently, and the prognosis is better in stage-1 patients (7,(13)(14)(15). In cases having extrapulmonary involvement together with pulmonary involvement, initial complaints may vary depending on the involved extrapulmonary sites.…”

Section: Discussionmentioning

confidence: 99%

The Role of Serum Angiotensin Converting Enzyme for Predicting Pulmonary Parenchymal and Extrapulmonary Involvement of Sarcoidosis

Yazici¹,

Karadağ²,

Ceylan³

et al. 2019

Kocaeli Med J

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Sarkoidoz günümüzde halen etiyolojisi bilinmeyen bir hastalıktır. Klinik tablo ve seyir hastalığın başlangıç yaşına, süresine, evresine ve yaygınlığına bağlı olarak değişmektedir. Klinik tabloyu ve seyri öngörebilecek biyomarkerların kullanılması hastalığın yönetiminde kolaylık sağlayacaktır. Çalışmamızda hematolojik ve biyokimyasal parametrelerle hastalığın evre ve yaygınlığı arasındaki ilişkiyi belirlemeyi amaçladık. YÖNTEM ve GEREÇLER: 2013-2018 yılları arasında kliniğimizde sarkoidoz tanısı konulan hastaların dosyaları retrospektif olarak incelendi. Hastaların demografik verileri, tanı sırasındaki klinik bulguları, evreleri, ekstrapulmoner tutulum olup olmadığı ve hemogram, eritrosit sedimentasyon hızı (ESR), C reaktif protein (CRP), serum kalsiyum (Ca) ve anjiotensin konverting enzim (ACE) düzeylerini içeren laboratuvar parametreleri kaydedildi. Hastalar akciğer parankim tutulumu ve ekstrapulmoner tutulumu olup olmamasına göre sınıflandırıldı. Akciğer parankim tutulumu olmayan evre 1 hastalar grup 1 ve akciğer parankim tutulumu olan evre 2 ve 3 hastalar grup 2 olarak sınıflandırıldı. BULGULAR: Belirlenen tarihler arasında 121 sarkoidoz hastasının verilerine ulaşıldı. Hastaların 30 (%24.8)'u erkek, 91 (%75.2)'i kadın ve yaş ortalaması 50.71±11.76 idi. Grup 1'de 59 (%48,8) ve grup 2'de 62 (%51,2) olgu vardı. Hastaların 71 (%58,9)'de sadece akciğer tutulumu varken 50 (%41.3)'sinde akciğer ve akciğer dışı organ tutulumu birlikte vardı. Akciğer dışı organ tutulumu en sık eritema nodozum (EN)'du (%15,7). Grup 2 olgularda serum ACE değeri grup 1'den daha yüksekti (p =0,027). Akciğer ve akciğer dışı tutulumu olan olgularda serum ACE düzeyi akciğer dışı tutulum olmayanlara göre daha yüksekti (p =0,045). Bakılan diğer laboratuvar parametreleri gruplar arasında farklı değildi. TARTIŞMA ve SONUÇ: Serum ACE düzeyi akciğer parankim tutulumunu ve ekstrapulmoner tutulumu göstermede faydalı olabilir.

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“…In patients affected by sarcoidosis, 18 F-FDG-PET and PET/CT can play an important role for assessing reversible granuloma, detecting occult diseases, evaluating treatment response and even indicating the most suitable site for biopsy [100,101]. In particular in stage IV that is characterized by fibrosis and mass-like lesions, 18 F-FDG uptake of reversible granulomas plays a key role in the diagnostic and therapeutic approach [102,103].…”

Section: F-fdgmentioning

confidence: 99%

Molecular Imaging of Pulmonary Inflammation and Infection

Giraudo

Evangelista

Fraia

et al. 2020

IJMS

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Infectious and inflammatory pulmonary diseases are a leading cause of morbidity and mortality worldwide. Although infrequently used in this setting, molecular imaging may significantly contribute to their diagnosis using techniques like single photon emission tomography (SPET), positron emission tomography (PET) with computed tomography (CT) or magnetic resonance imaging (MRI) with the support of specific or unspecific radiopharmaceutical agents. 18F-Fluorodeoxyglucose (18F-FDG), mostly applied in oncological imaging, can also detect cells actively involved in infectious and inflammatory conditions, even if with a low specificity. SPET with nonspecific (e.g., 67Gallium-citrate (67Ga citrate)) and specific tracers (e.g., white blood cells radiolabeled with 111Indium-oxine (111In) or 99mTechnetium (99mTc)) showed interesting results for many inflammatory lung diseases. However, 67Ga citrate is unfavorable by a radioprotection point of view while radiolabeled white blood cells scan implies complex laboratory settings and labeling procedures. Radiolabeled antibiotics (e.g., ciprofloxacin) have been recently tested, although they seem to be quite unspecific and cause antibiotic resistance. New radiolabeled agents like antimicrobic peptides, binding to bacterial cell membranes, seem very promising. Thus, the aim of this narrative review is to provide a comprehensive overview about techniques, including PET/MRI, and tracers that can guide the clinicians in the appropriate diagnostic pathway of infectious and inflammatory pulmonary diseases.

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Management strategies for pulmonary sarcoidosis

Cited by 13 publications

References 38 publications

Retrospective Evaluation of 100 Patients with Sarcoidosis in Gazi University, Turkey

Retrospective Evaluation of 100 Patients with Sarcoidosis in Gazi University, Turkey

The Role of Serum Angiotensin Converting Enzyme for Predicting Pulmonary Parenchymal and Extrapulmonary Involvement of Sarcoidosis

Molecular Imaging of Pulmonary Inflammation and Infection

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