The condition of patients with sarcoidosis after their transition to IV X-ray stage

Sarcoidosis is an epithelioid cell granulomatosis of unknown etiology. Its course varies from spontaneous remission to the development of fibrosis. The aim of the work was to evaluate the subjective and objective state of patients with sarcoidosis in the years following the detection of pulmonary fibrosis. Methods. 47 patients with sarcoidosis were examined at detection, during the transition to stage IV, and later. Results. One year after the detection of fibrosis, 46.3% of patients assessed their condition as unchanged, 39.0% as improved, and 12.2% as worsened. One patient died. HRCT did not change in 65.8%, improved in 24.5%, and worsened in 9.7%. FVC did not change in 36.6%, improved in 39.0%, and worsened in 24.4%. 22.0% of patients had saturation < 95% at baseline, and 17.1% after one year. After 2 – 3 years, the condition did not change in 53.7%, improved in 22.0%, and worsened in 24.4%. HRCT did not change in 28 (68.3%), improved in 7 (17.0%), and worsened in 6 (14.6 %). FVC did not change in 8 (19.5%), improved in 12 (29.3%), and worsened in 21 (51.2%). SpO2 was < 95% in 6 (14.6%) patients at baseline and in 11 (26.8%) after 2 – 3 years. After ≥ 4 years, the condition remained unchanged in 10 (62.5%), improved in 1 (6.3%), and worsened in 5 (31.3%). HRCT remained unchanged in 12 (75.0%) and worsened in 4 (25.0%). FVC did not change in 3 (18.8%), improved in 4 (25.0%), and worsened in 9 (56.2%). Saturation was < 95% in 2 (12.5%) at baseline and in 6 (37.5%) after 4 years. In all cases, the changes depended on compliance with the doctor’s recommendations and concomitant pulmonary diseases. Conclusion. Sarcoidosis progresses slowly in most patients with established fibrosis and may depend on both the correct initial therapy upon detection and concomitant bronchopulmonary diseases. We believe that further research should be directed towards developing criteria for prescribing antifibrotic therapy, the experience of using which in sarcoidosis is minimal.

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