Sarcoidosis and pregnancy

Sarcoidosis is usually a benign and self-limited disease, but it can occasionally be quite severe. It affects individuals most often during the reproductive years. This report reviews cases of sarcoidosis and pregnancy during a ten-year period at Downstate Medical Center. Eleven patients were stable, two experienced disease progression, and two died from complications of severe sarcoidosis. Factors indicating a poor prognosis included parenchymal lesions on chest x-ray, advanced roentgenologic staging, advanced maternal age, low inflammatory activity, requirement for drugs other than steroids, and presence of extrapulmonary sarcoidosis. Management plans are delineated for patients with advanced sarcoidosis. Some patients require evaluation before pregnancy to establish chronicity, baseline pulmonary function, inflammatory activity, roentgenographic staging, and response to treatment. Only then can the patient be given an accurate prognosis for either an uncomplicated pregnancy or one requiring intensive management by the pulmonary and perinatal teams.