Effects of corticosteroid treatment on pulmonary haemodynamics in patients with sarcoidosis

Abstract

Effects of 12 months steroid treatment on pulmonary haemodynamics in 24 patients with pulmonary sarcoidosis, stage II and III, were investigated. All patients had a chest radiograph, lung function tests, and pulmonary haemodynamics (measured at rest and during submaximal exercise) prior to the treatment. Resting pulmonary hypertension was found in 3 patients. In 18 an abnormal increase in pulmonary arterial mean pressure (PAP) on exercise was observed. All investigations were repeated after a year of treatment. In almost all patients (22) a regression of radiological changes in the lungs and improvement of pulmonary function were observed. The changes in pulmonary circulation were less uniform. In only half of the patients studied was regression of the disease seen on chest X-ray and improvement in lung function accompanied by improvement in pulmonary haemodynamics.

Sarcoidosis-Associated Pulmonary Hypertension

“…Despite little available data, it makes intuitive sense to control inflammation either before or in parallel to PH treatment in patients with SAPH and active parenchymal granulomas [1,8]. In an early series including 24 patients with pulmonary sarcoidosis, of whom 3 showed PH at rest and 18 showed PH on exercising, treated with 12 months of corticosteroids, 92% showed improvements on chest radiography and PFTs, but only half demonstrated improved hemodynamics [88]. In another study on 10 patients with SAPH, 3-6 months of corticosteroids resulted in a sustained amelioration of hemodynamics in 3/5 cases without pulmonary fibrosis, but no change in those 5 with stage IV [57].…”

Comorbidities of sarcoidosis

“…There is very limited data on the effect of anti-inflammatory treatment in SAPH, with variable results [ 13 , 16 , 22 ]. In patients with active parenchymal disease, it makes intuitive sense to control inflammation either before or in parallel to PH treatment.…”