Pulmonary sarcoidosis in a south Indian hospital: clinical and lung function profile

Twenty-two histopathologically proven cases of sarcoidosis were analyzed to determine the clinical presentation, lung function and the response to treatment. Laboratory data, chest x-ray and pulmonary function tests (PFT) were analyzed. Sarcoidosis was found to be more common in females in this study. Cough, breathlessness and weight loss were the predominant symptoms. Serum angiotensin converting enzyme (SACE) was elevated in 50% patients. Comparison of chest radiographs and PFT at the time of diagnosis revealed that stage I disease was associated with normal pulmonary function, 50% patients with stage II disease had mildly impaired PFT and 75% patient with stage III disease had severely impaired PFT. The indication for oral steroid treatment was respiratory symptoms in 58.8% of cases. Of the 13 patients who were available for follow up 10 (76.9%) had subjective improvement in symptoms. Majority of patients showed regression on chest radiograph but one patient progressed to stage IV disease. Pulmonary function data of the patients who were followed up showed improvement but this was not significant statistically. Oral corticosteroids improved symptoms but changes in pulmonary function seemed to be independent of steroid therapy. Further study of a larger number of patients over a longer period would be necessary.