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Pulmonary function in children with sarcoidosis
Insights
Pediatric sarcoidosis often presents with restrictive lung disease, impacting pulmonary function in children. However, lung function shows significant improvement over time, indicating potential for recovery.
Area of Science:
- Pulmonology
- Pediatric Medicine
- Rheumatology
Background:
- Sarcoidosis is a multisystem inflammatory disease that can affect the lungs.
- Pulmonary involvement is common in pediatric sarcoidosis, but functional abnormalities are not well-documented.
Purpose of the Study:
- To document pulmonary function abnormalities in children diagnosed with sarcoidosis.
- To assess changes in lung function over time in pediatric sarcoidosis patients.
Main Methods:
- Retrospective review of pediatric sarcoidosis cases at North Carolina Memorial Hospital.
- Spirometry performed at initial presentation and follow-up for a subset of patients.
Main Results:
- At presentation, 50% of children exhibited restrictive lung disease patterns.
- Fifteen percent showed obstructive changes; specific symptoms did not predict functional decrements.
- Significant improvement in lung function was observed at follow-up (mean % predicted FVC, 97.1 +/- 18.8).
Conclusions:
- Pediatric sarcoidosis frequently causes restrictive pulmonary dysfunction.
- Lung function in children with sarcoidosis can significantly improve over time.
- Auscultatory and radiographic findings correlate with more severe pulmonary function deficits.
Abstract:
To document pulmonary function abnormalities in children with sarcoidosis, we reviewed the records of all children with this disease at the North Carolina Memorial Hospital. Spirometry was performed by 34 of 60 children at initial presentation and was repeated by 16 at least 1 yr after presentation (mean, 3.9 yr). Those with and without pulmonary function data available were similar in age, sex, race, and clinical manifestations at presentation. Results indicate that at presentation, 50% of children had the characteristic functional changes of restrictive lung disease (mean % predicted FVC, 79.8 +/- 16.0). Fifteen percent had a FVC of 70 to 80% predicted, 32% had a FVC of 50 to 70% predicted, and 3% had a FVC less than 50% predicted. The TLC and FRC supported the diagnosis of restrictive lung disease. There were 15% who had obstructive changes. Children with auscultatory abnormalities and parenchymal changes on chest radiograph had more severe decrements in pulmonary function; however, specific symptoms did not predict decrements in pulmonary function. There was significant improvement in lung function at the last pulmonary function test performed (mean % predicted FVC, 97.1 +/- 18.8).