Sarcoidosis in north India: the clinical profile of 40 patients

Sarcoidosis is being increasingly recognized in India. Over the last 7 years we studied 40 patients. Older males out numbered young females. Thoracic (98%), constitutional (50%) and ocular (40%) involvement dominated the clinical profile. In addition, erythema nodosum (20%), facial palsy (13%), parotid enlargement (8%), lymphadenopathy (42%), hepatomegaly (37%) and splenomegaly (17%) were also observed. Radiologically, 53%, 30% and 15% of patients were in Stage I, II and III respectively at presentation. Kveim test was positive in 45% of those tested. The diagnosis was histologically confirmed in 80% of patients. The remaining eight patients (20%) were relatively asymptomatic, all had bilateral hilar lymphadenopathy and either erythema nodosum or uveitis or both. 88% were tuberculin negative. Systemic steroids were used in 60% and topical steroid eye drops in a further 20%. Response to therapy was excellent except in Stage III disease where radiological and spirometric deterioration was observed in three patients. There were no fatalities. The overall clinical behaviour of north Indian patients with sarcoidosis was quite similar to that of patients in England but different from previously reported Indian patients.