The relationship between disease duration and noninvasive pulmonary explorations in sarcoidosis with erythema nodosum

In order to investigate the initial course of pulmonary sarcoidosis, the following investigations were carried out in 14 nonsmoking patients with Logfren 's syndrome 3 to 12 wk after the onset of erythema nodosum (EN): bronchoalveolar lavage (BAL) (cellular and protein components), serum assays of lgG and of the activity of angiotensin-converting enzyme (SACE), and pulmonary function tests. These results were related to the disease duration, estimated by the time lapse separating the onset of EN from the investigations. All patients but one showed a large increase in the percentage of lymphocytes (%-L) in BAL fluid (more than 30%). Although each patient was evaluated only once, and thus this work was not an actual longitudinal study, a linear relationship between lymphocyte count per milliliter of recovered fluid during BAL (L-count) and disease duration was found during the first 8 wk (r = 0.78, p less than 0.01), suggesting a fast-developing alveolitis. The delayed rise in SACE level may indicate a secondary activation of macrophages; SACE and L-count were well related, either up to 8 wk (SACE versus L-count: r = 0.84, p less than 0.01) or up to 12 wk (SACE versus L-count: r = 0.61, p less than 0.01). Serum lgG levels were found to follow the L-count (serum lgG versus L-count: r = 0.79, p less than 0.01) and appeared to be a reliable index of disease activity. Respiratory function showed a univocal pattern, with a marked decrease in all of the patients in carbon monoxide diffusing capacity (DLCO), contrasting with normal lung volumes.(ABSTRACT TRUNCATED AT 250 WORDS)