Chest
Clinical InvestigationsSARCOIDOSISDelayed Cutaneous Hypersensitivity Tests and Lymphopenia as Activity Markers in Sarcoidosis
Section snippets
Study Population
The study protocol was prospectively applied for a period of 10 years to a series of 40 patients with biopsy-proven sarcoidosis, who were consecutively included in the study during this period. In each patient, this protocol was applied both at diagnosis and every 6 months during follow-up.
Clinical Evaluation
At each clinical visit, all patients were asked about their clinical manifestations and the findings of the following examinations that had been performed during the previous 30 days were assessed:
Results
The clinical features of patients belonging to the AcP or the AsP groups are shown in Table 1. Biochemical and hematologic parameters are shown in Table 2. With respect to the DCHTs (Table 3), their positivity was lower in the AcP than in the AsP, taking into account quantitative data (ie, mean diameter) and qualitative data (No. of positive tests) and considering the AGs separately (ie, the single-AG evaluation) or together (ie, global evaluation).
The percentages of periods (ie, appointments)
Discussion
The results of the present study show that the response to a DCHT, both qualitatively and quantitatively evaluated, is significantly lower during clinically active periods of the disease than in asymptomatic clinical situations. This difference exists both for each individual AG and for the sum of the four AGs (p < 0.0001) [Table 3]. Further, in the seven patients who throughout the follow-up period were studied both in AcPs and in AsPs, the difference for the sum of the four AGs was also lower
Conclusion
The results of the present study make it advisable to perform DCHTs as an activity marker in patients with sarcoidosis. S-ACE elevation and lymphopenia are also useful parameters that can be used in addition to DCHT results in the determination of disease activity. Other studies with longer follow-up periods should be conducted to determine whether the maintenance of repeatedly negative results during the follow-up of DCHTs implies a worsening in the clinical evolution of the disease.
ACKNOWLEDGMENT
We thank Tina Guerrero (graduate student in Mathematics) for help with statistical analysis of the data, Christine O'Hara for help with the English version of the article, and Rosa Llòria for editorial assistance.
References (21)
- et al.
Sarcoidosis
Am Rev Respir Dis
(1974) - et al.
Current concepts of the pathogenesis of sarcoidosis
Am Rev Respir Dis
(1987) - et al.
Bronchopulmonary sarcoidosis
Am Rev Respir Dis
(1996) - et al.
Pulmonary sarcoidosis: a disease characterized and perpetuated by activated lung T lymphocytes
Ann Intern Med
(1981) - Maga J, Salazar A, Pujol R, et al. Are the pulmonary function tests and the markers of activity helpful to establish...
Consensus conference: activity of sarcoidosis; third WASOG meeting, Los Angeles, USA, September 8–11, 1993
Eur Respir J
(1994)A study of the cutaneous reactions to oidiomycin, trichophytin and mumps skin test antigens in patients with sarcoidosis
Yale J Biol Med
(1952)- et al.
Altered immunologic reaction in sarcoidosis
Ann Intern Med
(1954) - et al.
The mumps skin test and complement fixation test as a diagnostic tool in sarcoidosis
J Invest Dermatol
(1955) Immunology of sarcoidosis
Lancet
(1996)
Cited by (0)
This research was supported by a grant from the Fundació Catalana de Pneumologia (FUCAP) and was presented in part at the 1998 International Conference of the American Thoracic Society in Chicago, IL.
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These authors contributed equally to the design of the study and to the writing of the article.