Clinical courses and prognoses of pulmonary sarcoidosis

Abstract

In this article, long-term prognoses and prognostic factors of patients with sarcoidosis are reviewed. In patients with intrathoracic sarcoidosis, functional impairments and parenchymal lesions at the time of initial examination strongly predicted an unfavorable prognosis. We also discussed the significance of extrathoracic lesions in terms of clinical outcomes of intrathoracic sarcoidosis. In addition, we focused on the genetic approach and the new insights being offering with respect to the disease susceptibility and the development of pulmonary lesions.

Association of HLA antigens with the clinical course of sarcoidosis and familial disease

“…Environmental, humoral, and hormonal factors may also play a role in the chronic and persistent disease. It is a well-known fact that the occasional occurrence of sarcoidosis in the first-degree relatives and identical twins suggests that genetic predisposition plays the most important role in the pathogenesis and thereby in the variable clinical manifestations of sarcoidosis [5,15,16]. The genetic background of sarcoidosis patients described by the HLA typing in clinical practice appears to be the most crucial factor determining the variable outcome of sarcoidosis for the individual patient is the most relevant finding of this study.…”

“…The patients who had manifestations of persistent disease after five years were classified as having a chronic nonresolving sarcoidosis. Patients without signs of active disease were denoted as stable disease [13][14][15]. Thirty patients received corticosteroids, four patients received azathioprine, and two patients received methotrexate for treatment.…”

Association of HLA-DRB1 with Sarcoidosis Susceptibility and Progression in African Americans

“…Although the recent report of the World Association of Sarcoidosis and Other Granulomatous Diseases Task Force on clinical outcome status in sarcoidosis recommended 5 years of follow-up, this recommendation was based on observations at only one clinical site and involved a more global view of disease status related to the need for therapy (53). Studies that have systematically followed patients for resolution of pulmonary involvement over the course of 5 years have found that, although the majority of patients who radiographically resolve do so within 2 years, as many as 10-20% of patients resolve between 2 and 5 years after diagnosis (54)(55)(56). However, data on long-term disease course in AfricanAmerican patients with sarcoidosis is lacking-one observational study that followed a cohort of African-American patient cohort for up to 12 years found that the majority of disease organ involvement was identified within 2 years of follow-up (57).…”

Multiple Bone Fractures Found in a Young Sarcoidosis Patient with Long Stable Disease

“…Pediphalangeal bone was also involved, and he suffered from multiple organ involvement including the brain, lungs, muscles, and lymph nodes. Although young sarcoidosis patients who present with stage I disease (BHL without parenchymal involvement on chest X-ray) and no extrathoracic lesion generally have good prognoses (15), the patient developed osseous and other multiple lesions after 7 years of stable disease. Previously reported cases of osseous sarcoidosis with bone fractures are summarized in Table 3.…”