X-ray, laboratory, and functional parallels in intrathoracic sarcoidosis


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Abstract

Aim: to compare respiratory function and laboratory data with the radiographic stages of intrathoracic sarcoidosis. Subjects and methods. Three hundred and eleven patients (70.4% for women and 29.6% for men; mean age, 44.7±0.6 years) with histologically verified sarcoidosis underwent X-ray computed tomography, spirography, estimation of carbon monoxide diffusing capacity (DLCO), oxygen saturation, blood count and serum total calcium blood test. The patients were assigned according to sarcoidosis stages as follows: 3.9% with stage 0; 16.4% with stage I; 65.3% with stage II; 13.2% with stage III; 1.3% with stage IV, and 12.9% with Löfgren’s syndrome. Results. DLCO decreased together with an increasing sarcoidosis stage (<80% of the due χ2=8.69 for DLCO; p=0.057); the difference was significant between stages I (84.2±2.8%) and III (76.1±2.9%, p=0.05). According to the radiographic changes, there were decreases in forced vital capacity (FVC) from 99.0±2.5% in stage I to 76.1±3.5% in Stage IV and in forced instantaneous expiratory flow rate at 75% of lung volume (FEF75) from 64.4±3.1 to 44.0±5.9%, respectively. DLCO correlated with FVC, peak expiratory flow, and FEF75 (p<0.01) and arterial oxygen saturation (SaO2) did only with FVC. There was a strong association between the decrease in DLCO and FVC below 80% of the due values (χ2=28.23; d.f.=1; p<0.001). Löfgren’s syndrome failed to affect functional data. In the patients with Löfgren’s syndrome, the serum level of calcium was significantly lower (2.09±0.10 versus 2.35±0.02 mmol/l (p=0.023); however, this indicator did not significantly differ between the radiological stages of intrathoracic sarcoidosis. Conclusion. In sarcoidosis, the changes in DLCO and FVC vary with radiological stages. Decreased SaO2 was observed in Stage IV. The total level of total blood calcium is an indicator independent of the radiological stages of sarcoidosis.

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