Pulmonary Function in Sarcoidosis

Marshall, Robert J.; Smellie, Hugh; Baylis, J. H.; Hoyle, Clifford; Bates, David V.

doi:10.1136/thx.13.1.48

Cited by 56 publications

(16 citation statements)

References 22 publications

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“…Abnormal pulmonary function tests without demonstrable roentgenographic in filtrates have been reported as well as nor mal pulmonary function tests with abnormal roentgenographic findings in sarcoidosis [1,12,20,21], Similar findings were observed in the present study. Discrepancies have also been reported between roentgenogra phic and structural changes [2], 19 patients with type 1 findings in this study all showed pathologic changes.…”

Section: Discussionsupporting

confidence: 82%

“…The lack of correlation was surpris ing inasmuch as diffusing capacity is in part a volume dependent function and correla tive changes in the two parameters might be reasonably assumed [12,22]. Divergent re sults for these parameters, however, have been reported following steroid therapy by Jones ei al.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical course of pulmonary sarcoi dosis and its response to therapy has been described by investigators usually in terms of roentgenographic findings [8,17] or pul monary function abnormalities [1,3,4,10,12,[18][19]20]. Only a few authors have re lated the clinical or functional findings to structural changes.…”

Section: Introductionmentioning

confidence: 99%

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Pulmonary Sarcoidosis

Ct¹,

Ae²,

Rosen³

et al. 1979

Respiration

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Discrepancies were observed between functional (PFT), chest roentgenographic, and open lung biopsy findings (granulomata, interstitial pneumonitis, angiitis, and fibrosis) in 81 patients with clinical diagnosis of sarcoidosis. A combination of normal PFT and Type 1 roentgenographic findings (hilar lymphadenopathy) was associated with minimal lung lesions without fibrosis. Type 1 findings alone did not preclude extensive lesions or fibrosis. Advanced roentgenographic and PFT abnormalities correlated with the presence of extensive lung lesions. The pulmonary diffusing capacity correlated best with specific and overall lung pathology, and roentgenographic types. Only this test differentiated the extent of granulomata and the roentgenographic types. Moderate degrees of other pathologic changes were not distinguished by any other PFT. Degrees of overall lung pathology correlated with an individual PFT and most significantly with overall PFT (p < 0.001). Serial studies of PFT are a practical and valuable means for assessment of the disease process in sarcoidosis.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

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Pulmonary Sarcoidosis

Ct¹,

Ae²,

Rosen³

et al. 1979

Respiration

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“…Patients 35 and 36, with sarcoidosis, show considerable variation, the former having a normal DM but a low value of Ve, and the latter having a normal V, and a nearly normal DM. These variations in this condition are to be expected, and the low V, found in Patient 35 may reflect the fact that the main brunt of the lesion has been perivascular, as has been suggested by a number of authors (15,16) for this condition. It is of interest, however, that the considerable difference in V, between these two patients is not reflected by much difference in the over-all DL.…”

Section: Calculationsmentioning

confidence: 87%

Variations in the Pulmonary Capillary Blood Volume and Membrane Diffusion Component in Health and Disease*

Bates¹,

Varvis²,

Donevan³

et al. 1960

J. Clin. Invest.

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Forster, Roughton and their colleagues (1, 2) have reported a method of subdividing the components of the pulmonary diffusing capacity by measurement of the apparent diffusing capacity at different alveolar oxygen tensions. This development followed preparatory work by the same authors (3,4) in which the kinetic factors involved in CO and hemoglobin combination were reported. The principles underlying the measurements have been fully discussed by Forster in a recent review (5).Lewis, Lin, Noe and Komisaruk (6) reported on the measurement of pulmonary capillary blood volume in normal subjects, using the single breath method of determining the pulmonary diffusing capacity. They found average values of 65 ml for the pulmonary capillary blood volume at rest and 98 ml CO per minute per mm Hg for the membrane diffusion component. In four subjects both of these quantities increased somewhat during exercise. They did not report any results on patients. McNeill, Rankin and Forster (7), using a similar technique of measuring the pulmonary diffusing capacity by a single breath method, found similar values at rest for the pulmonary capillary blood volume, but a lower value for the membrane component, which was about 63.5 ml CO per minute per mm Hg in normal subjects at rest. These authors reported the results of this measurement in five patients with various types of pulmonary fibrosis, two with pulmonary hypertension, two with pulmonary congestion, and three with chronic obstructive emphysema. The most significant findings were the decrease in membrane diffusion component ib patients with pulmonary fibrosis, and the increase generally found in pulmonary capillary blood volume in patients with increased pressure in the lesser circulation.The present study reports the measurement of * Supported by a grant from the National Research Council of Canada.these two components of the pulmonary diffusing capacity by a steady state method during exercise in 14 normal subjects and in a group of 22 patients. This work was undertaken to study the reliability of the results obtainable with this technique, and to explore its usefulness in investigative work. METHODSThe apparatus used in this work has recently been described in full (8). A steady state measurement of diffusing capacity (DL) is made, the mean alveolar CO tension being calculated from an assumed value of respiratory dead space. Technical details and a study of the errors of this method have been presented previously (8). The determination of pulmonary capillary blood volume (Va) and membrane diffusion component (DM) involves the measurement of the pulmonary diffusing capacity at two different oxygen tensions. Each experiment whether on a normal subject or a patient consisted in the measurement of the diffusing capacity on either 60 or 100 per cent oxygen, followed by its determination on air. All estimates were made during moderate or light exercise.In a typical determination, the subject attained a steady state on the exercise treadmill for 5 minutes, and was then switch...

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“…All patients should be studied during exercise if possible, since not only are the method errors reduced by the increased tidal volume it produces, but the discrimination between normal and abnormal is sharpened. These advantages have been stressed in a number of recent studies of gas diffusion (2,3,20,32,33). SUMMARY 1.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Function in Sarcoidosis

Cited by 56 publications

References 22 publications

Pulmonary Sarcoidosis

Pulmonary Sarcoidosis

Variations in the Pulmonary Capillary Blood Volume and Membrane Diffusion Component in Health and Disease*

The Measurement of the Pulmonary Diffusing Capacity in the Presence of Lung Disease

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