Sarcoidosis is a multisytem disease characterized by non-caseating granulomas that predominantly affect the lungs. Standard treatment is effective but the effects of treatment has not been completely characterized.
We surveyed consecutive patients with sarcoidosis undergoing evaluation at the pulmonary clinic of an urban tertiary care hospital using a questionnaire. Additional data was abstracted from patients medical records.
Of 50 respondents, 60% were females and 40% males. Blacks were 84%, Whites 4.8% and Hispanics 4.8%. The mean duration of disease was 12.04 years, SD 12.64. Family history of sarcoidosis was present in 18%. Radiographic stage was evaluable in 45 patients at survey time; stage 0: 8.89%, stage 1: 17.78%, stage 2: 57.78%, stage 3: 6.67%, and stage 4: 8.89%. 44 patients(88%) received tissue biopsy for diagnosis, most commonly lung 63.6%, and skin 22.7%. 82% reported receiving treatment for sarcoidosis of which 97.6% received prednisone, 12.2% methotrexate, 7.3% azathioprine, and 7.3% hydroxychloroquine. Mean duration of treatment was 8.58 years, SD 9.39. 61% were still on treatment at the time of the survey. 82.9% reported improvement with treatment. However 33/41 reported weight gain, 10/41 depression, 6/41 new diagnosis of diabetes mellitus, and 7/41 bone loss. The mean weight gain was 27.55Lbs, SD 39.75. 92% reported having symptoms in the preceeding six months, most commonly dyspnea 74%, cough 66%, and fatigue 64%. In the 2 weeks prior to survey, 46% could walk over 2 blocks or without limitation, 18% could walk 2 blocks, and 36% could walk under 2 blocks.
Sarcoidosis has significant impact among urban patients despite receiving treatment for this disease. Treatment improves symptoms in many patients but incomplete resolution is common. Side effects of treatment are common and significant.
Safer and more effective treatments are needed.
Charles Ojielo, No Financial Disclosure Information; No Product/Research Disclosure Information