New observations on pulmonary function changes in sarcoidosis

Abstract

Respiratory tract involvement occurs at some time during the course of most patients with sarcoidosis. There are many articles on lung function impairment in sarcoidosis, but the definite, unique guideline considering the correlation between the clinical, radiologic, and biochemical findings of the disease is lacking. During the last few years, most of the literature has focused on follow-up studies, presenting primarily the effects of the treatment on lung function impairment in patients with sarcoidosis. This study focuses on airflow impairment, diffusion impairment, and bronchial hyperresponsiveness in sarcoidosis. The topic has already been explored, but this time the authors emphasize lung function impairment and its correlation with the course of the disease. Considering the course of sarcoidosis, a significantly higher number of patients with diffusion impairment have the chronic form of the disease. The bronchial challenge test (BCT) was performed in patients with chronic sarcoidosis at the time they experienced relapse of disease activity. A high number of patients with positive BCT is significant in light of their disease. Further analyses, not only functional, but immunologic, are necessary to examine the potential correlation between positive BCT and the activity of sarcoidosis.

Clinical presentations and diagnostic work-up in sarcoidosis: a series of Turkish cases (clinics and diagnosis of sarcoidosis)

“…Similar findings have been reported in another study (7). In a large study of German and Swiss patients, more than 20% of patients at initial diagnosis had restrictive disease (10).…”

“…Stage I and II sarcoidosis have been reported as the most frequent forms in many studies similar to the present study (3,7).…”

“…Pulmonary diffusion impairment have been reported in 50% of the sarcoidosis patients (7). In the recent study, 34.5% of the patients were reported as having DLco below 75% predicted.…”

Pulmonary Sarcoidosis

“…64,81 Additionally, increased airway hyperreactivity in response to methacholine is common in patients with sarcoidosis. [82][83][84] Clinically, this may manifest as chronic, hacking cough. In one study, 50% of patients with stage I or II sarcoidosis exhibited bronchial hyperreactivity following methacholine challenge.…”

“…12 A more recent series cited bronchial hyperreactivity in 46 of 80 (58%) sarcoid patients. 84 Bronchial hyperreactivity likely reflects granulomatous inflammation involving the bronchial mucosa. 71 Clinical bronchiectasis is a rare complication of stage IV sarcoidosis.…”