Review of Sarcoidosis in a Province of South Korea from 1996 to 2014

Background: Since the introduction of endobronchial ultrasound (EBUS)–guided transbronchial needle aspiration (TBNA) of mediastinal lymph nodes, the incidence of histopathologically-confirmed sarcoidosis has increased. Methods: The electronic medical records of Chonnam National University (CNU) Hospital and CNU Hwasun Hospital (CNUHH) were searched for confirmed cases of sarcoidosis diagnosed between 1996 and 2014. Cases were selected using a combination of clinical, radiological, and pathological evidence. Of 115 cases with the relevant disease codes, 16 cases were excluded, as they had not been confirmed pathologically or had no definitive clinical features of sarcoidosis. Results: Among 99 cases of confirmed sarcoidosis, only nine patients were diagnosed with sarcoidosis before 2008; the rest were diagnosed from 2008 onward, after the introduction of EBUS-TBNA. EBUS-TBNA was used in 75.8% of patients, open surgical biopsy in 13.2%, and mediastinoscopic biopsy in 5.1%. At the time of diagnosis, 42.4% of sarcoidosis cases were at stage I, 55.6% at stage II, and 2% at stage III. Spontaneous remission of sarcoidosis was observed in 33.3% of cases, and stable disease in 37.4%; systemic steroid treatment was initiated in 23.2% of cases. Of the patients treated with systemic steroids, 69.6% showed improvement. The median duration of steroid treatment was 5 months. Conclusion: Following the introduction of EBUS-TBNA, the number of newly diagnosed sarcoidosis patients has increased. Clinical features of sarcoidosis were similar to those previously reported. Spontaneous remission occurred in about one-third of patients, while one-fourth of patients required systemic steroid treatment.

keywords: Sarcoidosis, Bronchoscopy, Endoscopic Ultrasound-Guided Fine Needle Aspiration

Reference

1. Rybicki BA, Major M, Popovich J Jr, Maliarik MJ, Iannuzzi MC. Racial differences in sarcoidosis incidence: a 5-year study in a health maintenance organization. Am J Epidemiol 1997;145:234-41.

2. Bresnitz EA, Strom BL. Epidemiology of sarcoidosis. Epidemiol Rev 1983;5:124-56.

3. Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999. Am J Respir Crit Care Med 1999;160:736-55.

4. Iannuzzi MC, Rybicki BA, Teirstein AS. Sarcoidosis. N Engl J Med 2007;357:2153-65.

5. Kim DS, Ahn JJ. Sacoidosis in Korea. Tuberc Respir Dis 2000;49:274-80.

6. Scientific Committee in Korean Academy of Tuberculosis and Respiratory Diseases. National survey of sarcoidosis in Korea. Tuberc Respir Dis 1992;39:453-73.

7. World Health Organization. International statistical classification of diseases and related health problems. 10th revision. Geneva: World Health Organization; 2009.

8. Schemper M, Smith TL. A note on quantifying follow-up in studies of failure time. Control Clin Trials 1996;17:343-6.

9. Rybicki BA, Iannuzzi MC, Frederick MM, Thompson BW, Rossman MD, Bresnitz EA, et al. Familial aggregation of sarcoidosis: a case-control etiologic study of sarcoidosis (ACCESS). Am J Respir Crit Care Med 2001;164:2085-91.

10.

10. Hosoda Y, Sasagawa S, Yasuda N. Epidemiology of sarcoidosis:new frontiers to explore. Curr Opin Pulm Med 2002;8:424-8.

11.

11. Polychronopoulos VS, Prakash UB. Airway involvement in sarcoidosis. Chest 2009;136:1371-80.

12.

12. Bjermer L, Thunell M, Rosenhall L, Stjernberg N. Endobronchial biopsy positive sarcoidosis: relation to bronchoalveolar lavage and course of disease. Respir Med 1991;85:229-34.

13.

13. de Boer S, Milne DG, Zeng I, Wilsher ML. Does CT scanning predict the likelihood of a positive transbronchial biopsy in sarcoidosis? Thorax 2009;64:436-9.

14.

14. Descombes E, Gardiol D, Leuenberger P. Transbronchial lung biopsy: an analysis of 530 cases with reference to the number of samples. Monaldi Arch Chest Dis 1997;52:324-9.

15.

15. Annema JT, Veselic M, Rabe KF. Endoscopic ultrasoundguided fine-needle aspiration for the diagnosis of sarcoidosis. Eur Respir J 2005;25:405-9.

16.

16. Gupta D, Dadhwal DS, Agarwal R, Gupta N, Bal A, Aggarwal AN. Endobronchial ultrasound-guided transbronchial needle aspiration vs conventional transbronchial needle aspiration in the diagnosis of sarcoidosis. Chest 2014;146:547-56.

17.

17. Dziedzic DA, Peryt A, Orlowski T. The role of EBUS-TBNA and standard bronchoscopic modalities in the diagnosis of sarcoidosis. Clin Respir J 2017;11:58-63.

18.

18. Studdy PR, Bird R. Serum angiotensin converting enzyme in sarcoidosis: its value in present clinical practice. Ann Clin Biochem 1989;26(Pt 1):13-8.

19.

19. Kim YW. Sarcoidosis. J Korean Med Assoc 2009;52:41-8.

20.

20. Baughman RP, Lower EE, Kaufman AH. Ocular sarcoidosis. Semin Respir Crit Care Med 2010;31:452-62.

21.

21. Bonfioli AA, Orefice F. Sarcoidosis. Semin Ophthalmol 2005;20:177-82.

22.

22. Paramothayan S, Jones PW. Corticosteroid therapy in pulmonary sarcoidosis: a systematic review. JAMA 2002;287:1301-7.

23.

23. Paramothayan NS, Lasserson TJ, Jones PW. Corticosteroids for pulmonary sarcoidosis. Cochrane Database Syst Rev 2005;(2):CD001114.

바로가기메뉴

Article Contents

Vol.80 No.3

Review of Sarcoidosis in a Province of South Korea from 1996 to 2014

Abstract

Reference

Tuberculosis & Respiratory Diseases