Sarcoidosis, with Special Reference to Lung Changes

Scadding, J. G.

doi:10.1136/bmj.1.4656.745

Cited by 86 publications

(18 citation statements)

References 6 publications

(8 reference statements)

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“…There is considerable evidence for overlap between sarcoidosis and tuberculosis (Scadding 1964). The diseases have been observed simultaneously and sequentially in the same patient (Scadding 1950), in identical twins ) and in the same family. Epidemiological studies have shown that in certain countries a surge in the incidence of sarcoidosis follows in the wake of an epidemic of tuberculosis (Morrison 1974).…”

Section: Introductionmentioning

confidence: 88%

Is Micropapular Sarcoidosis Tuberculosis?

Ridgway

Ryan

1981

J R Soc Med

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Section: Introductionmentioning

confidence: 88%

Is Micropapular Sarcoidosis Tuberculosis?

Ridgway

Ryan

1981

J R Soc Med

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“…Nevertheless, most investigators have accepted the concept that patients with this disease are abnormally sensitive to vitamin D. Evidence for this view includes reports of toxicity from use of calciferol in sarcoidosis (Scadding, 1950;Mather, 1957), observations of adverse effects of sunlight (Ellman & Parfitt, 1960) and the report of increased frequency of hypercalcaemia in summer months (Taylor et al, 1963). The effect of sunlight, however, has not been confirmed in two prospective studies; the toxic effects of calciferol may be independent of hypercalcaemia (Robertson, 1948); and we have used calciferol in treatment of several patients with disfiguring cutaneous sarcoids; no increases in calcium levels occurred.…”

Section: Discussionmentioning

confidence: 99%

Frequency of disordered calcium metabolism in sarcoidosis

Israel

Goldstein

1970

Postgraduate Medical Journal

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“…The most likely source of infection in Cases 1 *and 3 is an unsuspected latent focus such as a gland, for both had normal chest x-ray appearances before treatment ; but it is possible that Case 2 is an example of tuberculous sarcoidosis (Scadding, 1950) and that tubercle bacilli would have appeared in the sputum eventually had she not been treated with prednisone. It has been suggested that in disseminated lupus erythematosus (Harrison, 1950;Brit.…”

Section: Discussionmentioning

confidence: 99%

“…The exact relationship of sarcoidosis to tuberculosis is still uncertain, though Scadding (1950) believes that a proportion of cases are tuberculous and has shown that some eventually develop a positive sputum. Steroids are, however, widely used in treatment (Whitfield, 1959;Shulman et al, 1952;Israel et al, 1954;Hoyle et al, 1955;Smellie, 1958), and of these authors only Hoyle et al discuss the advisability of combining antituberculous therapy with steroids.…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis Occurring During Steroid Therapy

Mackinnon¹

1959

BMJ

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NEPHRECTOMY FOR HYPERTENSIONDelayed Cure Case 216 is classed as a failure though his blood pressure was reduced from 195/125 to 160/105 for one year, and he actually had some pre-operative readings of 190/140. The reason for this is the relatively short follow-up period. If he remains well at the present level for three years he might be reviewed later as a possible cure. This also applies to Cases 29 and 30. Case 14 is claimed under the 20% reduction as a success in view of vast clinical benefit maintained for four years; actually the diastolic pressure has continued to fall and is now 85 mm. Hg, and he could be regarded as a cure by any standards; a further justification of the 20% allowance. Case 218 is a late failure after eight years' relief. Case 16 is the only one that would not justify the 20% reduction, for though the diastolic pressure fell from 140 to 110 mm. Hg for three years, it then relapsed to 130 mm. Hg. He is therefore classified as a failure.The 20% reduction in diastolic pressure seems to be justified as an additional claim for cure if there is marked clinical benefit and the follow-up is extended for three years. Also it would be better if "good result" or "good effect" were claimed rather than " cure."9 Summary and ConclusionThe literature on the subject of nephrectomy for hypertension is discussed and reasons for a more optimistic approach to this problem are advanced.Agreement is noted on the investigations required.Eighty-nine personal cases of nephrectomy for unilateral renal disease in hypertension are reviewed and 66 accepted for analysis.Criteria for a claim of success are discussed and a new standard is suggested.The 66 nephrectomies have been analysed and a 45.5% cure is claimed, for which a diastolic pressure of 90 mm. Hg for one year is required. In addition, a few patients symptomatically cured for three years with a 20% fall in the diastolic pressure (even if remaining above 90 mm. Hg) are included.If the additional claim of those with a 20% fall in diastolic pressure is rejected, the claim for cure is 37.9%.The younger the patient the better the result.Patients over 50 seldom benefit unless the hypertension is recent.While every patient must be considered and assessed as an individual problem it is hoped that a more optimistic approach may be made to these cases.Certainly hypertension in young people must be investigated for a renal cause, and early nephrectomy of a suspected kidney will offer these patients a 50% chance of cure. The number of patients who have been adversely affected by such treatment must be very small; I have not encountered any.It is recommended that a diastolic pressure of 90 mm. Hg be required for one year to claim a good result, but that patients who have been symptomatically cured for three years with a 20% fall in the diastolic pressure should also be included as good results.I thank Mr. P. Holmes, Mr. C. Q. Henriques, Miss Gadsby, oand Miss Henriksen for help in tracing the follow-up of cases.

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Sarcoidosis, with Special Reference to Lung Changes

Cited by 86 publications

References 6 publications

Is Micropapular Sarcoidosis Tuberculosis?

Is Micropapular Sarcoidosis Tuberculosis?

Frequency of disordered calcium metabolism in sarcoidosis

Tuberculosis Occurring During Steroid Therapy

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