Abstract
Background. Sarcoidosis is a multisystem granulomatous condition of uncertain aetiology that most frequently affects the lungs. Because of clinical and radiological similarities with tuberculosis, particularly in high-prevalence regions, sarcoidosis is frequently misdiagnosed as TB.Objective. To review the clinical features of sarcoidosis patients in an SApopulation, adding clinical information to the relatively few studies that have been conducted in SA patients with sarcoidosis.
Methods. This was a retrospective study of 102 sarcoidosis patients conducted between 2002 and 2006 at the Charlotte Maxeke Johannesburg Academic Hospital.Results. Of 102 sarcoidosis patients, there were 69 (67.6%) females and 33 (32.4%) males. The majority (85.3%) were non-smokers. The mean age of the group was 44.6 years. One-third of patients had chronic comorbid diseases. Almost 17% had been treated initially for TB, prior to being diagnosed as having sarcoidosis. Two patients developed active TB while receiving corticosteroid treatment for sarcoidosis. The salient clinical manifestations were dry cough (the most common presenting symptom in 82.4%), dyspnoea in 53.9%, cutaneous lesions other than erythema nodosum in 33.3%, and on lung examination crackles were noted in 37.3% of patients. Raised angiotensin-converting enzyme (ACE) levels were found in 56.8% of patients. The majority (48%) of patients had stage II chest radiographic changes. Cutaneous (28.4%), mediastinal lymph node (25.5%) and transbronchial lung (25.5%) biopsies were the most frequent sites confirming granulomatous inflammation. Overall, 21.2% of patients had obstructive airway disease. Systemic corticosteroids were indicated in 87.3% of patients and the relapse rate was 60.7%.
Conclusion. Sarcoidosis is often initially misdiagnosed as TB in SA. The most common biopsy sites for histological confirmation were the skin and mediastinal lymphnodes, and transbronchial lung biopsies were also frequently taken. Stage II chest radiographic changes were most common. Overall, systemic corticosteroids were administered in 87.3% of cases and the relapse rate was 60.7%.
Publisher
South African Medical Association NPC
Subject
Infectious Diseases,Critical Care and Intensive Care Medicine,Pulmonary and Respiratory Medicine
Reference67 articles.
1. Sharma O. Sarcoidosis around the world. Clin Chest Med 2008:357-363. https:// doi.org/10.1016/j.ccm.2008.03.013.
2. Benatar S. Sarcoidosis in South Africa. A comparative study in Whites, Blacks and Coloureds. S Afr Med J 1977;52(15):602-606.
3. Smith C, Feldman C, Reyneke J, Promnitz D, Kallenbach J, Zwi S. Sarcoidosis in Johannesburg – a comparative study of black and white patients. S Afr Med J 1991;80(9):423-427.
4. Hunninghake G, Costabel U, Ando M, et al. ATS/ERS/WASOG statement on sarcoidosis. American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and other Granulomatous Disorders. Sarcoidosis Vasc Diffuse Lung Dis 1999;16(2):149-173.
5. Rybicki BA, Major M, Popovich JJ, Maliarik M, Iannuzzi M. Racial differences in sarcoidosis incidence: A 5-year study in a health maintenance organisation. Am J Epidemiol 1997;145(3):234-241. https://doi.org/10.1093/oxfordjournals.aje. a009096
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献