Prognosis of Asymptomatic Pulmonary Sarcoidosis_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 ChengLinling ¹ , LiuYaya ² , SuZhuquan ¹ , LiuJun ¹ , GuYingying ¹ , ZhongNanshan ¹

1. National Clincal Reseach Center for Respiratory Desease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, China;
2. ;

Corresponding author：

ChengLinling, Email: linling@gird.cn

Keywords：

Sarcoidosis; Prognosis; CD4/CD8 T-cell ratio; Tumor necrosis factor

DOI：

10.7507/1671-6205.2014069

Video：

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Objective To assess the prognosis of asymptomatic pulmonary sarcoidosis with normal lung function. Methods Eighty-two patients with asymptomatic pulmonary sarcoidosis,diagnosed in Guangzhou Institute of Respiratory Diseases between July 2007 and November 2013,were followed for 24 months.The clinical data were collected and analyzed. Results 31.7% of the patients showed spontaneous remission without therapy,whereas 39.0% deteriorated and 29.3% remain stable.There was no significant difference between the remission group and the progressive sarcoidosis group with regard to FEV₁.17.1% of patients in the progressive sarcoidosis group had a decline in FEV₁,while 73.8% had a reduced FVC,and 28.3% had a reduced D_LCO.At the beginning of observation,TNF-α level was higher in the progressive sarcoidosis group compared with the remission group and the stable group[(173.5±37.8) μg/mL vs.(102.6±82.7) μg/mL and(131.7±57.9) μg/mL,P<0.05].In the progressive sarcoidosis group,TNF-α at the end time of the observation was higher than that at the beginning[(229.2±76.7) μg/mL vs.(173.5±37.8) μg/mL,P<0.05].The neutrophil in BALF was significantly higher in the progressive sarcoidosis group compared with the remission group[(10.6±4.6)% vs.(8.68±5.2)%,P<0.01). There were no significant differences between the progressive sarcoidosis group and the remission group with regard to CD4/CD8 T-cell ratio and the expression of angiotensin converting enzyme(ACE) in lung tissue.Non-necrotizing granulomas rate in endobronchial biopsy was 63.6% in the progressive sarcoidosis group,54.9% in the remission group,and 58.4% in the stable group,respectively,without significant difference between three groups(P>0.05) but was significantly different between three groups at the end time of the observation(69.1% vs.12.7% and 36.2%,P<0.05). Conclusion Nearly 40% asymptomatic pulmonary sarcoidosis are likely to deteriorate.The increase of TNF-α and BALF neutrophils may indicate the progress of sarcoidosis.

Citation： ChengLinling, LiuYaya, SuZhuquan, LiuJun, GuYingying, ZhongNanshan. Prognosis of Asymptomatic Pulmonary Sarcoidosis. Chinese Journal of Respiratory and Critical Care Medicine, 2014, 13(3): 286-290. doi: 10.7507/1671-6205.2014069 Copy

1.	Baughman RP,Culver DA,Judson MA.A concise review of pulmonary sarcoidosis.Am J Respir Crit Care Med,2011,183:573-581.
2.	Morgenthau AS,Iannuzzi MC.Recent advances in sarcoidosis.Chest,2011,139:174-182.
3.	彭忠民,刘奇,王永康,等.电视纵隔镜联合CD4/CD8对纵隔结核和结节病的诊断价值.中华结核和呼吸杂志,2007,30:595-598.
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5.	Chen ES,Moller DR.Etiology of sarcoidosis.Clin Chest Med,2008,29:365-377.
6.	Baughman RP,Judson MA,Teirstein A,et al.Presenting characteristics as predictors of duration of treatment in sarcoidosis.QJM,2006,99:307-315.
7.	Paramothayan NS,Lasserson TJ.Corticosteroids for pulmonary sarcoidosis.Cochrane Database Syst Rev,2005,CD001114.
8.	Baughman RP,Costabel U.Treatment of sarcoidosis.Clin Chest Med,2008,29:533-548.
9.	Drent M,Wirnsberger RM.Association of fatigue with all acute phase response in sarcoidosis.Eur Respir J,1999,13:718-722.
10.	丁可,徐作军,黄慧,等.结节病59例治疗与随访分析.中华内科杂志,2007,46:52-55.
11.	Danila E,Jurgauskien L,Malickaite R.BAL fluid cells and pulmonary function in different radiographic stages of newly diagnosed sarcoidosis.Adv Med Sci,2008,53:228-233.
12.	Drent M,Jacobs JA,de Vries J,et al.Does the cellular bronchoalveolar lavage fluid profile reflect the severity of sarcoidosis? Eur Respir J,1999,13:1338-1344.
13.	Ziegenhagen MW,Rothe ME,Schlaak M,et al.Bronchoalveolar and serological parameters reflecting the severity of sarcoidosis.Eur Respir J,2003,21:407-413.
14.	Pietinalho A,Ohmichi M,Lofroos AB,et al.The prognosis of sarcoidosis in Finland and Hokkaido,Japan.A comparative five-year study of biopsy-proven cases.Sarcoidosis Vasc Diffuse Lung Dis,2000,17:158-166.
15.	Izbicki G,Chavko R,Banauch GI,et al.World Trade Center "sarcoid-like" granulomatous pulmonary disease in New York City Fire Department rescue workers.Chest,2007,131:1414-1423.

1. Baughman RP,Culver DA,Judson MA.A concise review of pulmonary sarcoidosis.Am J Respir Crit Care Med,2011,183:573-581.
2. Morgenthau AS,Iannuzzi MC.Recent advances in sarcoidosis.Chest,2011,139:174-182.
3. 彭忠民,刘奇,王永康,等.电视纵隔镜联合CD4/CD8对纵隔结核和结节病的诊断价值.中华结核和呼吸杂志,2007,30:595-598.
4. Baughman RP,Teirstein AS.Clinical characteristics of patients in a case control study of sarcoidosis.Am J Respir Crit Care Med,2001,164:1885-1889.
5. Chen ES,Moller DR.Etiology of sarcoidosis.Clin Chest Med,2008,29:365-377.
6. Baughman RP,Judson MA,Teirstein A,et al.Presenting characteristics as predictors of duration of treatment in sarcoidosis.QJM,2006,99:307-315.
7. Paramothayan NS,Lasserson TJ.Corticosteroids for pulmonary sarcoidosis.Cochrane Database Syst Rev,2005,CD001114.
8. Baughman RP,Costabel U.Treatment of sarcoidosis.Clin Chest Med,2008,29:533-548.
9. Drent M,Wirnsberger RM.Association of fatigue with all acute phase response in sarcoidosis.Eur Respir J,1999,13:718-722.
10. 丁可,徐作军,黄慧,等.结节病59例治疗与随访分析.中华内科杂志,2007,46:52-55.
11. Danila E,Jurgauskien L,Malickaite R.BAL fluid cells and pulmonary function in different radiographic stages of newly diagnosed sarcoidosis.Adv Med Sci,2008,53:228-233.
12. Drent M,Jacobs JA,de Vries J,et al.Does the cellular bronchoalveolar lavage fluid profile reflect the severity of sarcoidosis? Eur Respir J,1999,13:1338-1344.
13. Ziegenhagen MW,Rothe ME,Schlaak M,et al.Bronchoalveolar and serological parameters reflecting the severity of sarcoidosis.Eur Respir J,2003,21:407-413.
14. Pietinalho A,Ohmichi M,Lofroos AB,et al.The prognosis of sarcoidosis in Finland and Hokkaido,Japan.A comparative five-year study of biopsy-proven cases.Sarcoidosis Vasc Diffuse Lung Dis,2000,17:158-166.
15. Izbicki G,Chavko R,Banauch GI,et al.World Trade Center "sarcoid-like" granulomatous pulmonary disease in New York City Fire Department rescue workers.Chest,2007,131:1414-1423.

Chinese Journal of Respiratory and Critical Care Medicine

Prognosis of Asymptomatic Pulmonary Sarcoidosis

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