|
14 Mar 2004 |
Health-Related Quality of Life of Persons
With Sarcoidosis. (Chest,
Mar 2004; 125: 997-1004.)
Health-related
quality of life (HRQL) measurement may provide unique insight
into the impact that sarcoidosis has on a patient’s life.
A study at three university medical center outpatient pulmonary
clinics evaluated the HRQL and mental health of 111 outpatients
with sarcoidosis seen between March and July 2002. The
HRQL of sarcoidosis patients was measured using surveys and
questionnaires. Outpatients with sarcoidosis had moderate
to severely low HRQL and patients receiving therapy with oral
corticosteroids had significantly worse HRQL than patients who
were not taking steroids. Depression and stress levels
were also assessed. The prevalence of depression was 66%
and significant stress was 55% among sarcoidosis patients.
|
|
1 Feb 2004 |
Pulmonary sarcoidosis: new genetic clues
and ongoing treatment controversies. (Cleve
Clin J Med. 2004 Feb;71(2):88-106.)
While the cause or causes of sarcoidosis are
unknown, there have been significant recent advances in the
understanding of genetic and immunologic features. Genetic
predisposition appears to be important in the development,
presentation and course of sarcoidosis. However, to date, no
gene or set of genes has been identified that sufficiently
explains the development of sarcoidosis. Studies to
identify specific genes determining risk for sarcoidosis have
concentrated on human leukocyte antigen (HLA) genes, which are
important determinants of immune response. Studies
worldwide have implicated a multitude of HLA genes. Most
likely, the tendency to develop the disease is a product of
multiple genetic factors including polymorphisms governing
immune regulation, T-cell function or antigen processing and
presentation.
|
|
1 Jan 2004 |
Rheumatologic manifestations of
sarcoidosis. (Curr Opin Rheumatol. 2004 Jan;16(1):51-5.)
Although pulmonary disease is the most frequent
manifestation of sarcoidosis, musculoskeletal symptoms are not
only common, but may be the initial presentation of this
systemic inflammatory process and could mimic other arthritic
and autoimmune disorders. This article focuses on the
rheumatological aspects of sarcoidosis and includes a review of
the most recent literature, which shows new data on the
diagnosis, pathogenesis, and treatment of this condition.
|
|
1 Dec 2003 |
Abnormal warm and cold sensation
thresholds suggestive of small-fibre neuropathy in sarcoidosis.
(Clin
Neurophysiol. 2003 Dec;114(12):2326-33.)
A substantial number of sarcoidosis patients
report non-specific symptoms such as pain. This
study attempted to verify small-fibre neuropathy in a group of
sarcoidosis patients using various electrophysiological tests.
In 74 sarcoidosis patients complaining of symptoms suggestive of
small-fibre neuropathy thresholds for warm (WS) and cold
sensation (CS) were determined. Testing revealed abnormalities in 51 of the 74 patients. WS was
affected more often than CS and feet were affected more often
than hands. CONCLUSIONS: Small-fibre neuropathy may be the
cause of a number of unexplained symptoms in sarcoidosis.
|
|
1 Oct 2003 |
Two year prognosis of sarcoidosis: the
ACCESS experience. (Sarcoidosis
Vasc Diffuse Lung Dis. 2003 Oct;20(3):204-11.)
215 sarcoidosis patients from the ACCESS study
underwent evaluation at study enrollment and two years later.
Data indicate that sarcoidosis tends to improve or remain stable
over two years in the majority of patients. Several factors
associated with improved or worse outcome over two years were
identified. Patients with erythema nodosum (red bumps on the
skin) at presentation were more likely to have improvement in
the chest x-ray at two-year follow-up. Patients with a lower
annual family income were more likely to worsen with respect to dyspnea (shortness of breath) and more likely to have new organ
involvement at two-year follow-up. The development of new organ
involvement over the two year follow-up period was more common
in African-Americans compared to Caucasians and more likely in
those with involvement outside the lungs at study entry.
|
|
1 Sept 2003 |
An increased frequency of carpal tunnel
syndrome in sarcoidosis. Results of a study based on nerve
conduction study.
(Acta
Medica. 2003;46(4):201-4.)
Sarcoidosis is a systemic disease which can affect the
musculoskeletal system; however, its association with carpal
tunnel syndrome (CTS) has been reported only rarely. This
study of 56 patients at one center in Turkey looked at the
prevalence of CTS in sarcoidosis patients based on their
symptoms and nerve conduction study (NCS). The results of
NCS detected a high prevalence (41%) of CTS in sarcoidosis
patients, even though most of the patients did not have symptoms of pain
or numbness.
|
|
1 Aug 2003 |
Cutaneous involvement in sarcoidosis:
analysis of the features in 170 patients.
(Respir
Med. 2003 Aug;97(8):978-82.)
This study retrospectively evaluated the clinical
symptoms of patients diagnosed with sarcoidosis at one center in
Turkey over the last 36 years. Skin involvement was
diagnosed in approximately one-third of all sarcoidosis patients
with a generally female majority (of 170 patients with skin
involvement, 136 were female and 34 were male). When patients
with skin involvement were compared to other sarcoidosis
patients, it was seen that the frequency of females among those
with skin involvement was significantly higher than the
frequency among other sarcoidosis patients. Erythema nodosum
(red bumps on the skin) was the most frequent skin lesion
encountered.
|
|
1 Jul 2003 |
Sarcoidosis: benefits of a
multidisciplinary approach. (Eur
J Intern Med. 2003 Jul;14(4):217-220.)
It is well established that sarcoidosis is a
multisystem disorder of unknown cause and almost no organ is
immune to the disease. Pulmonary (lung) and extrapulmonary
(other organ) complications may occur. This requires the
attention of pulmonologists as well as specialists from other
medical disciplines. An approach
that coordinates the efforts of specialists with different areas of training and
that focuses attention on physical as well
as psychological and social aspects of this erratic disorder is
recommended when treating sarcoidosis patients.
|
|
1 Jun 2003 |
A prospective study of 32 patients with
neurosarcoidosis. (Sarcoidosis
Vasc Diffuse Lung Dis. 2003 Jun;20(2):118-25.)
Doctors at the Prince Charles Hospital in
Australia prospectively studied 123 sarcoidosis patients from 1991 to 1994
to establish the incidence of neurological (brain, nervous
system) involvement. CONCLUSIONS: Neurological involvement
was found more commonly than previously reported (26%, 32/123
patients). A formal neurological examination was
recommended in all patients with sarcoidosis as neurological
involvement may be overlooked.
|
|
29 Mar 2003 |
Sarcoidosis. (Lancet.
2003 Mar 29;361(9363):1111-8.)
Corticosteroids remain the standard of care for treatment of
sarcoidosis, but immunosuppressive drugs have proved
steroid-sparing for many patients. New agents, including
pentoxifylline, thalidomide, and infliximab have proved useful
in selected cases. The effectiveness of these agents seems to
lie in their ability to block tumor necrosis factor (TNF),
especially in the treatment of chronic disease.
|
|
1 Jan 2003 |
Treatment of sarcoidosis from a basic
science point of view. (J
Intern Med. 2003 Jan;253(1):31-40.)
Progress in the understanding of the scientific basis of
granulomatous inflammation in sarcoidosis provides a framework
for enlightened treatment decisions. Current evidence supports
the concept that the pathogenesis of sarcoidosis involves a
highly polarized T-helper 1 (Th1) immune response to pathogenic
tissue antigens. Conventional treatment is focused on hindering
granuloma formation with antimalarial drugs that inhibit antigen
presentation or with nonspecific anti-inflammatory agents such
as glucocorticosteroids, methotrexate, or azathioprine. Anti-tumour
necrosis factor (TNF)-alpha agents such as pentoxifylline,
thalidomide, etanercept and remicade, have recently shown some
successes in sarcoidosis. Designing future therapies depends on
improved knowledge of the critical immunological processes
operative in different stages of disease.
|
|
1 Oct 2002 |
Update of ocular manifestations in
sarcoidosis. (Sarcoidosis
Vasc Diffuse Lung Dis. 2002 Oct;19(3):167-75.)
Although the lung is the primary target of involvement,
sarcoidosis can involve any organ in the body, including the
eye. Ocular (eye) involvement may also be the initial symptom of
sarcoidosis in many patients. Early recognition and intervention
are essential for the reduction of ocular damage and the
improvement of the patient's quality of life. Since no
single clinical feature predicts the onset of eye involvement in
sarcoidosis, a thorough eye examination is advised.
|
|
1 Sept 2002 |
Sarcoidosis and other autoimmune
disorders. (Curr
Opin Pulm Med. 2002 Sep;8(5):452-6.)
The relation between sarcoidosis and autoimmune disorders was
first suggested by Telium about half a century ago. Now, the
inclusion of sarcoidosis into the group of disorders of
autoimmunity is a discarded notion. Sarcoidosis does not meet
the criteria for autoimmune disease. Nevertheless, there are
ample examples of coexistence of sarcoidosis and a wider range
of autoimmune disorders.
|
|
15 June 2002 |
Small Fiber Neuropathy in Sarcoidosis.
(Lancet.
2002 Jun 15;359(9323):2085-6.)
Some
patients with sarcoidosis have unexplained pain and impairment
of the sense of touch. Testing was done 31 sarcoidosis patients
with pain or autonomic dysfunction, 25 had reduced warmth
sensitivity, cold sensitivity, or both. Skin biopsy samples in
seven consecutive patients confirmed the presence of small fiber
neuropathy. Conclusion: Some patients with sarcoidosis may
have small fiber neuropathy with autonomic involvement.
|
|
13 Mar 2002 |
Corticosteroid therapy in pulmonary
sarcoidosis: a systematic review. (JAMA. 2002 Mar
13;287(10):1301-7.) Corticosteroids are
used in pulmonary sarcoidosis to reduce symptoms and minimize
long-term damage. A systematic review of randomized trials was
done to assess the effect of oral and inhaled corticosteroids on
chest radiograph results, symptoms, pulmonary function and
long-term outcome in pulmonary sarcoidosis. The search
identified 150 studies; 9 met the inclusion criteria, but only 8
provided usable data. CONCLUSIONS: Oral corticosteroids improved
results on the chest radiograph following 6 to 24 months of
treatment and produced a small improvement in vital capacity and
diffusing capacity. Trials of inhaled corticosteroids were small
and results too inconsistent to make firm conclusions concerning
their efficacy. There are no data to suggest that corticosteroid
therapy alters long-term disease progression.
|
|
1 Dec 2001 |
Familial aggregation of sarcoidosis. A
case-control etiologic study of sarcoidosis (ACCESS). (Am
J Respir Crit Care Med., 2001 Dec 1;164(11):2085-91.)
Despite individual reports, little evidence
exists that risk of sarcoidosis is greater among family members
than in the general population. Using patients enrolled in
ACCESS, researchers estimated sarcoidosis familial relative risk
by collecting data on disease rates in 10,862 first and 17,047
second-degree relatives. A significant elevated risk of
sarcoidosis was observed among first and second-degree relatives
of sarcoidosis cases compared with relatives of control
subjects. Siblings had the highest relative risk, followed
by aunts and uncles, grandparents and then parents. White cases
had a markedly higher familial relative risk compared with
African-American cases.
|
|
1 Nov 2001 |
Clinical Characteristics of Patients in a
Case Control Study of Sarcoidosis. (Am.
J. Respir. Crit. Care Med., 2001 Nov 15;164(10 Pt
1):1885-9.) A Case
Control Etiologic Study of Sarcoidosis (ACCESS) enrolled 736
patients with sarcoidosis from 10 clinical centers in the United
States. The study population was 53% white and 44% black, with
64% female participants. Initial results indicated that in the
United States organ involvement differed according to race, sex
and age. Women were more likely to have eye and neurologic
involvement, have erythema nodosum, and to be age 40 yr or over
whereas men were more likely to be hypercalcemic. Black subjects
were more likely to have skin involvement other than erythema
nodosum, and eye, liver, bone marrow, and extrathoracic lymph
node involvement.
|
|
1 Mar 2000 |
Methotrexate is steroid sparing in acute
sarcoidosis: results of a double blind, randomized trial.
(Sarcoidosis
Vasc Diffuse Lung Dis. 2000 Mar;17(1):60-6.)
Researchers aimed to determine whether
methotrexate could be steroid sparing in the first year of
corticosteroid therapy in sarcoidosis. Patients with new onset
sarcoidosis within four weeks of starting on prednisone were
randomized to receive either methotrexate or placebo for the
next year. They were seen monthly and prednisone dosage was
tapered following a pre-determined schedule. Less prednisone
used for the methotrexate patients versus placebo. There was
also less weight gain for those patients receiving methotrexate.
CONCLUSIONS: Methotrexate can be a steroid sparing agent in
acute sarcoidosis.
|
|
1 Aug 1999 |
Statement on Sarcoidosis.
(Am.
J. Respir. Crit. Care Med., Volume 160, Number 2,
August 1999, 736-755.) The American
Thoracic Society (ATS), in collaboration with the European
Respiratory Society and the World Association of Sarcoidosis and
Other Granulomatous Disorders, issued a consensus statement on
sarcoidosis which provides information on the epidemiology,
pathogenesis, diagnosis and treatment of sarcoidosis. It was
written by a 14-member panel of authorities on sarcoidosis who
primarily developed the recommendations on the basis of expert
opinion and consensus. |
