Clinical spectrum of sarcoidosis varies among different populations. The purpose of our study was to report the clinical spectrum of the disease in our center.
Retrospective study of 20 patients’ records admitted to our hospital for sarcoidosis during a 5-year period (1998–2002). Data included patients’ demographics, medical history, clinical presentation, radiographic findings, bronchoscopy and biopsy results.
20 patients’ records were studied, 14 female and 6 male. The median age was 39.2±11 years.According to radiological staging, eight patients were evaluated as stage I, seven as stage II, and five as stage III.CD4/CD8 ratio in bronchoalveolar lavage was higher than 3.5 in all cases.In 11/20 patients the diagnosis was confirmed by transbronchial biopsy, in 2/20 by mediastinoscopy and 3/20 by skin biopsy, whilst 4/20 were diagnosed by bronchoalveolar lavage and clinicoradiological findings.Common symptoms were cough (40%), dyspnoea (35%) and weight loss (30%). Nine patients had both common and uncommon extrapulmonary manifestations. 7/9 had cutaneous lesions (erythema nodosum, sarcoidic cutaneous granulomas, coexistence with psoriasis). One patient had Loffgren’s syndrome and another had Heerford’s syndrome.Three patients had ophthalmic lesions.One female patient with a previous history of breast cancer developed a breast lump, the histopathological examination of which revealed sarcoidic granuloma.Tuberculin skin test (PPD) was positive in 3/20. One of them had concomitant sarcoidosis and active tuberculosis.In 2/20 sarcoidosis coexisted with rheumatoid arthritis.Transbronchial biopsy showed in one patient the coexistence of sarcoidosis and bronchiolitis obliterans organizing pneumonia (BOOP).CONCLUSIONS: Unusual presentations of sarcoidosis were found in 7/20 cases (BOOP, active tuberculosis, sarcoid breast granuloma, Heerford’s syndrome, concomitance with psoriasis and rheumatoid arthritis).
Any form of sarcoidosis can be encountered in our country and clinicians should consider all these different forms in the differential diagnosis of sarcoidosis.
E. Passalidou, None.