British Journal of Medicine and Medical Research, ISSN: 2231-0614,Vol.: 9, Issue.: 1
Clinical Features and Prognostic Significance of Endobronchial Sarcoidosis
H. Yanardag1, C. Tetikkurt2*, M. Bilir1, S. Demirci1, A. BakÄ±r3 and M. Åženocak3 1Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University, Turkey.
2Department of Pulmonary Medicine, Cerrahpasa Medical Faculty, Istanbul University, Turkey.
3Department of Bioistatistics, Cerrahpasa Medical Faculty, Istanbul University, Turkey.
H. Yanardag1, C. Tetikkurt2*, M. Bilir1, S. Demirci1, A. BakÄ±r3 and M. Åženocak3
1Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University, Turkey.
(1) Alexander D. Verin, Vascular Biology Center, Georgia Regents University Augusta, Georgia.
(1) Madiha Mahfoudhi, Department of Internal Medicine A, Charles Nicolle Hospital, Tunisia.
(2) Anonymous, University of Rio de Janeiro, Brazil.
(3) Anonymous, USA.
Complete Peer review History: http://www.sciencedomain.org/review-history/9683
Aims: Endobronchial involvement may occur in patients with sarcoidosis. Although the prevalence of bronchial abnormalities is high, there are no firm data establishing the clinical features and prognosis of sarcoidosis in these patients. The aim of our study was to define the clinical characteristics and prognosis of patients with endobronchial sarcoidosis.
Methods: Clinical and laboratory findings of 44 patients with endobronchial sarcoidosis and 46 patients without endobronchial involvement seen at our institution, were evaluated retrospectively. The patients fulfilled clinical, radiologic or both features of sarcoidosis supported by the histopathologic evidence of noncaseating granulomas. Six to ten bronchial biopsies were taken from each patient. The sample was considered positive if it demonstrated noncaseiting granulomas with negative bacterial, fungal and mycobacterial cultures.
Results: Bronchial biopsy was more positive in 84% of the abnormal appearing airways, biopsy provided diagnostic tissue in 32% of the normal appearing mucosa. The most frequent bronchoscopic finding was miliary infiltration followed by nodular and erythematous lesions. Serum ACE, serum and urinary Ca levels were higher (51.4±14.3 IU/L vs 37.3±15.1 IU/L, p<0.01; 8.42±3.6 mg/dL vs 10.8±2.9 mg/dL, p<0.01; 244.9±32.4 mg/day vs 379.6±36.8 mg/day, p<0.01) in patients with endobronchial involvement. There was no significant difference between FEV1, FVC, TLC and DLCO/VA. The extrapulmonary organ involvement (p<0.02) and progressive disease (p<0.03) was more frequent in patients with endobronchial disease.
Conclusion: Endobronchial involvement in sarcoidosis appears to be a significant predictive risk factor for progressive disease. Extrapulmonary organ involvement was also higher in these patients contributing to a worse prognosis.
Sarcoidosis; endobronchial sarcoidosis; bronchoscopy; prognosis.
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DOI : 10.9734/BJMMR/2015/18441Review History Comments