Chest
Volume 94, Issue 2, August 1988, Pages 343-346
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Airway Obstruction in Sarcoidosis: A Study of 123 Nonsmoking Black American Patients with Sarcoidosis

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Airway obstruction in sarcoidosis is infrequent; however, its exact incidence is not known. The extent and severity of the functional impairment are governed by genetic, racial and environmental factors. In order to test the validity of this assumption we studied 123 black American, nonsmoking patients. Airway obstruction was present in 78 (63 percent) of the patients, considerably higher than the white European and American, and the Japanese patients.

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PATIENTS AND METHODS

One hundred twenty three black American nonsmoking patients with clinical, radiologic and histologic evidence of pulmonary sarcoidosis were consecutively selected from the sarcoidosis clinic at the Los Angeles County-University of Southern California Medical Center. Of 123 patients 109 (88 percent) had never smoked; 14 patients had infrequently smoked in the past but not during the five-year period preceding this study The sex and age distributions are shown in Table 1. The diagnosis of

METHODS

Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) and maximal voluntary ventilation (MVV) were measured with a 13-L Stead-Wells spirometer. A modification of the single-breath method (Forster) was used to measure diffusing capacity for carbon monoxide (DCO). Reference values for spirometry were those of Morris et al15 and Seltzer et al16 and a 13 percent reduction factor was used for those patients of African ancestry. The DCO and coefficient of diffusion (Kco)

RESULTS

The results of these studies are tabulated in Table 2, Table 3, Table 4.

COMMENT

In this study of 123 black nonsmokers with sarcoidosis, 78 (63 percent) were found to have reduced FEV1/FVC ratio. Thus, about two thirds of our patients on whom simple spirometry tests were done showed mild to severe airway obstruction. Although the incidence is considerably higher than is generally realized, it is consistent with the observation that sarcoidosis tends to be more extensive in black Americans, among whom it carries a poor prognosis.18, 19, 20, 21, 22, 23, 24, 25 Lung function

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    Manuscript received November 16; revision accepted January 21.

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