Document Detail

Airway obstruction in bronchial sarcoidosis: outcome with treatment.
MedLine Citation:
PMID:  10559075     Owner:  NLM     Status:  MEDLINE    
STUDY OBJECTIVE: Airway obstruction (AO) in sarcoidosis is reported to be associated with respiratory symptoms, increased morbidity, and an increased mortality risk. Because AO in sarcoidosis may result from several causes, the therapeutic benefit of corticosteroids is difficult to determine. The aim of this study was to evaluate the therapeutic response of AO attributable to sarcoid granulomas in the bronchial wall.
PATIENTS: We selected 11 patients who had sarcoidosis with AO (defined as FEV(1)/vital capacity [VC] < 70%) associated with sarcoid granulomas on an endobronchial biopsy. Exclusion criteria were history of asthma, smoker or ex-smoker, stage 4 disease, evidence of extrinsic compression by enlarged lymph nodes, and localized endobronchial stenosis seen during fiberoptic bronchoscopy.
INTERVENTIONS: We compared the results of pulmonary function tests and clinical, radiologic, and biological findings at baseline with those obtained at the time of the last pulmonary function tests available, between the sixth and 12th months of treatment. Eight patients took oral corticosteroids (20 to 60 mg/d initially), one received IV methylprednisolone pulses, another took oral hydroxychloroquine, and the last one received IM methotrexate.
MEASUREMENTS AND RESULTS: With treatment, FEV(1) and FEV(1)/VC significantly improved in eight patients (72%), normalized in four patients, and was unchanged in the remaining three patients. The mean FEV(1) increased from 60.8 +/- 10.8% to 76 +/- 13.7% of the predicted value (p < 0.02). VC did not change significantly. FEV(1)/VC increased from 76.1 +/- 6.4% to 87.6 +/- 10.7% of the predicted value (p < 0.01). Dyspnea on exertion and other clinical findings were attenuated in 10 patients; the chest radiograph improved in 9 patients, and normalized in 5 patients. The mean serum angiotensin-converting enzyme level decreased from 112 +/- 48 to 58 +/- 40 IU/mL (p < 0.05), and normalized in four patients.
CONCLUSION: The present study indicates that AO caused by sarcoid granulomas in the bronchial wall can be either partially or completely reversed by treatment with a concomitant attenuation of pulmonary symptoms.
F Lavergne; C Clerici; D Sadoun; M Brauner; J P Battesti; D Valeyre
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Chest     Volume:  116     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1999 Nov 
Date Detail:
Created Date:  1999-11-30     Completed Date:  1999-11-30     Revised Date:  2014-07-28    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1194-9     Citation Subset:  AIM; IM    
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MeSH Terms
Administration, Oral
Airway Obstruction / diagnosis,  drug therapy*,  etiology
Antirheumatic Agents / administration & dosage,  therapeutic use*
Bronchial Diseases / complications,  diagnosis,  drug therapy*
Follow-Up Studies
Glucocorticoids / administration & dosage,  therapeutic use*
Hydroxychloroquine / administration & dosage,  therapeutic use
Methotrexate / administration & dosage,  therapeutic use
Methylprednisolone / administration & dosage,  therapeutic use
Middle Aged
Radiography, Thoracic
Respiratory Function Tests
Retrospective Studies
Sarcoidosis, Pulmonary / complications,  diagnosis,  drug therapy*
Treatment Outcome
Reg. No./Substance:
0/Antirheumatic Agents; 0/Glucocorticoids; 4QWG6N8QKH/Hydroxychloroquine; X4W7ZR7023/Methylprednisolone; YL5FZ2Y5U1/Methotrexate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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