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[Airway responsiveness in sarcoidosis]
Sonia Regina da Silva Carvalho1, Ricardo Marques Dias, Denise Duprat Neves
1Disciplina de Pneumologia da Universidade Federal do Estado do Rio de Janeiro. Mestre pela Universidade Federal Fluminense.
Revista Portuguesa De Pneumologia
|June 11, 2005
Summary
Airway responsiveness, measured by methacholine bronchoprovocation testing (BPT), was found in 17.6% of sarcoidosis patients, often linked to symptoms and active disease. BPT effectively distinguished asthmatics from asymptomatic individuals.
Area of Science:
- Pulmonology
- Respiratory Medicine
- Clinical Investigation
Background:
- Sarcoidosis is an inflammatory disease that can affect the airways.
- Assessing airway hyperresponsiveness is crucial for understanding respiratory conditions.
- Bronchoprovocation testing (BPT) with methacholine is a standard method to evaluate airway responsiveness.
Purpose of the Study:
- To measure airway responsiveness in sarcoidosis patients using methacholine bronchoprovocation testing (BPT).
- To correlate BPT results with roentgenographic findings, respiratory symptoms, and disease characteristics.
- To compare airway responsiveness in sarcoidosis patients, asthmatics, and asymptomatic individuals.
Main Methods:
- A tidal breathing method was employed for methacholine BPT.
- Increasing concentrations of methacholine (0.125 to 16 mg/ml) were administered.
- Airway responsiveness was quantified by the concentration of methacholine causing a 20% fall in FEV1 (PC20).
Main Results:
- Four out of 17 sarcoidosis patients (23.5%) exhibited positive BPT, with three having PC20 < 8 mg/ml.
- Positive BPT in sarcoidosis patients was associated with respiratory symptoms, bilateral hilar adenopathy, and active, chronic disease (>2 years).
- All asthmatic subjects had positive BPT (PC20 < 8 mg/ml), while all asymptomatic subjects had negative BPT.
Conclusions:
- Airway responsiveness is present in a subset of sarcoidosis patients (17.6%), particularly those with specific clinical and radiological features.
- Methacholine BPT is a valuable tool for differentiating asthmatic patients from those with sarcoidosis and asymptomatic individuals.
- Approximately 50% of sarcoidosis patients experiencing cough or wheeze showed a positive BPT, indicating significant airway involvement.