Chest
Clinical Investigations: SarcoidosisOutcome in Sarcoidosis: The Relationship of Relapse to Corticosteroid Therapy
Section snippets
MATERIALS AND METHODS
Patients with documented sarcoidosis who were examined during a 4-year period were enrolled in the registry, and hospital and office records of these patients were used as data sources. Documentation of the disease was based in most instances on demonstration of noncaseating granulomas found in biopsy specimens of the pulmonary parenchyma, lymph nodes, skin, conjunctiva, or liver. In asymptomatic patients, a diagnosis was made without biopsy only if a gallium scan demonstrated characteristic
RESULTS
Three hundred thirty-seven patients were enrolled in the sarcoidosis registry over a 4-year period. One hundred three of these were judged to have had an induced remission lasting longer than 1 month following cessation of treatment; corticosteroid therapy had been discontinued by the treating physician. Of these, 76 developed clinical relapse, yielding a relapse rate of 74% in patients with induced remission who were examined during the 4 years of the study period. One hundred eighteen of the
DISCUSSION
Following cessation of corticosteroid therapy for longer than 1 month in patients judged to have had adequate treatment for sarcoidosis, 74% developed clinically significant relapse. In contrast, relapse was unusual in patients who had never been treated with steroids. When relapse occurred, it frequently involved organ systems other than those involved at initial presentation of sarcoidosis.
Our findings are consistent with a limited study of clinical relapse in patients with sarcoidosis during
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