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RESUMO
O autor revê a terapêutica actual da doença sarcoide, essencialmente a do envolvimento pulmonar, mas também das manifestaçõoes multisistémicas mais frequentes. Na introdução tece comentários breves sobre epidemiologia, etiopatogenia, anatomia patológica e diagnóstico da doença sarcoide. Faz análise crítica dos indicadores de extensão e actividade da doença (radiografia e tomografia computorizada torácica, estudo funcional respiratório, enzima convertor de angiotensina, cintigrafia com Ga67 e lavado broncoalveolar).
Os corticosteroides são a terapêutica mais adequada, embora não haja unanimidade relativamente a quando iniciá-los, dose mínima eficaz, duração do tratamento e influência no curso do processo granulomatoso. Na sarcoidose pulmonar com sintomas respiratórios significativos, estudo funcional respiratório anormal e radiografias torácicas com alterações difusas, deve efectuar-se tratamento. Recomenda-se uma dose inicial de (prednisona/prednisolona) 0,5 mg/kg/dia em toma (mica durante 3 meses, progressivamente reduzida para 10-15 mg/dia e 12 a 18 meses de terapêutica. Têm sido experimentados outros fármacos: metotrexato, clorambucil, azatioprina, cidosporina, cloroquina.
Duas terapêuticas recentes são de considerar: corticosteróides inalados e transplante pulmonar. São considerados aspectos particulares na terapêutica da sarcoidose extrapulmonar (ocular, cutânea, cardíaca, neurológica, renal, gastrointestinal, hepática, óssea, pleural) e no controle da hipercalcemia e da hipercalciuria. A sarcoidose é uma doenç granulomatosa multisistémica com grande variabilidade de apresentação clfnica e evolução imprevisível. Globalmente, o prognóstico é bom. Pode acontecer: remissão espontânea ou terapêutica (60-70%); actividade persistente com lesoes residuals estáveis e repercussão clínico-funcional minima (20-30%); ou doença progressiva e incapadtante apesar de terapêutica corticosteroide (10-20%). A taxa de mortalidade é baixa (4%), sendo a fibrose pulmonar a mais frequente causa de morte.
SUMMARY
The author review the current concepts in the management of sarcoidosis, namely in the most common involved tissues (lungs and intrathoracic lymph nodes. It is done a brief commentary about incidence, etiology, pathogenesis and diagnosis of sarcoid disease. It is analized the techniques useful in assessing the extent and activity of sarcoidosis (chest radiographs, high resolution computorized tomography, pulmonary function tests, serum angiotensin – converting enzyme, Gallium67 scans, bronchoalveolar lavage).
Corticosteroides are generally considered to be adequated treatment of sarcoidosis, but there is no establish criterious about when to start, the minimal effective dose, the duration, and the effect of therapy on the course of the granulomatous process. All patients with respiratory symptoms, abnormal pulmonary function test and diffuse changes on chest radiographs need therapy. Generally an initial dose of 0,5mg/kg of prednisone daily during the first three months, progressively reduced to 10-15 mg/day is adequate. A course of 12 to 18 months is recommended. In patients who do not respond to tolerable doses of steroids, alternative drug therapy must be considered (methotrexate, chlorambucil, azathioprine, cyclosporine, chloroquine). Two recent therapies are under consideration: inhaled steroids and lung transplantation. It’s considered particular aspects of extrapulmonary sarcoidosis treatment (ocular, cutaneous, cardiac, neurologic, renal, gastrointestinal, hepatic, osseous) and hypercalcaemia, hypercalcinuria.
Sarcoidosis is a multisystem granulomatous disorder of unknown etiology with diverse clinical presentation and a variable natural history. In general prognostic is good (spontaneous resolution is common). Mortality is low (4%) and pulmonary fibrosis is the most frequent cause of death.
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BIBLIOGRAFIA
[1.]
D.G. James, J. Turiaf, Y. Hosoda, et al.
Description of sarcoidosis: Report of the subcommittee on classification and definition.
Ann NY Acad Sci, 278 (1976), pp. 742
[2.]
A. Teirstein, M. Lesser.
Worldwide distribution and epidemiology of sarcoidosis.
Sarcoidosis and Other Granulomatous Diseases of the Lung, pp. 101-134
[3.]
N. Milman, O. Selroos.
Pulmonary Sarcoidosis in the Nordic Countries 1950-1982. Epidemiology and clinical picture.
Sarcoidosis, 7 (1990), pp. 50
[4.]
J.L. Da Costa.
Geographic epidemiology of sarcoidosis in Southeast Asia.
Am Rev Respir Dis, 108 (1973), pp. 1269
[5.]
J.G. Scadding.
Sarcoidosis.
Eyre and Spottiswoode, (1967),
[6.]
P. Purriel, E. Navarrete.
Epidemiology of sarcoidosis in Uruguay and other countries of Latin America.
Am Rev Respir Dis, 84 (1961), pp. 155
[7.]
A.Z. Keller.
Anatomic sites, age attributes, and rates of sarcoidosis in US veterans.
Am Rev Respir Dis, 107 (1973), pp. 615
[8.]
D. Honeybourne.
Ethnic differences in the clinical features of sarcoidosis in south-east London.
Br J Dis Chest, 74 (1980), pp. 63
[9.]
R.L. Mayork, P. Bertrand, C.E. Morrison, et al.
Manifestations of sarcoidosis. Analysis of 145 patients, with a review of nine series selected from the literature.
Am J Med, 35 (1963), pp. 67
[10.]
Y. Hirshant, P. Glade, Lobo Viena.
Sarcoidosis: Another disease associated with serologic evidence of herpes like virus infection.
N Engl J Med, 283 (1970),
[11.]
V. Richters, R.P. Sherwin, O.P. Sharma.
Pulmonary sarcoidosis: Electron microscopic study of cytoplasmic and nuclear inclusion bodies.
Sarcoidosis, 2 (1985), pp. 67
[12.]
E. Uesaka, T. Izumi, S. Tsuki.
Nocardialike organism isolated from lesions of sarcoidosis.
pp. 3
[13.]
J. Vanek, J. Schwarz.
Demonstration of acid rods in sarcoidosis.
Am Rev Respir Dis, 101 (1970), pp. 395
[14.]
E. Mankiewicz, M. Van Walbeck.
Mycobacteriophages: their role in tuberculosis and sarcoidosis.
Arch Environ Health, 5 (1962), pp. 122
[15.]
B.U. Bowman, T.M. Daniel.
Further evidence against the concept of decreased phage neutralizing ability of serum of patients with sarcoidosis.
Am Rev Respir Dis, 104 (1971), pp. 908
[16.]
B.U. Bowman, W.T. Amos, J.C. Geer.
Failure to ptoduce experimental sarcoidosis in guinea pigs with M. tuberculosis and mycobacteriophage DSBA.
Am Rev Respir Dis, 105 (1972), pp. 85
[17.]
O.P. Sharma.
Sarcoidosis: Clinical Management.
Butherworths, (1984),
[18.]
J. Chapman, M. Speight.
Further studies of mycobacterial antibodies in the sera of sarcoidosis patients.
Atca Med Scand, 176 (1964), pp. 67
[19.]
R.A. Vogel, A.M. Thrash.
Pine pollen granulomas in animals.
Am Rev Respir Dis, 84 (1961), pp. 130
[20.]
N.L. Spince, D.S. Tilles, H. Ryll.
Beryllium case registry Update after 30 years.
Sarcoidosis, 2 (1985), pp. 57
[21.]
W.B. Shelley, H.J. Hurley JR..
Experimental sarcoid reactions in human skin.
Am Rev Respir Dis, 84 (1961), pp. 35
[22.]
E. Lebacq, V. Desmet.
Sarcoid granulomas associate with phenylbutazone treatment.
Mt Sinai J Med, (1977),
[23.]
J.G.B. Thurston, P. Marks, D. Trapnell.
Lung changes associated with phenylbutazone treatment.
Br Med J, 4 (1976), pp. 1422
[24.]
R. Harf, C. Ethevenaux, M. Perrin-Fayolle, et al.
Sarcoidosis a disease commoner in non-smokers. Results of a case control study. Proceedings of the XthInternational Conference on Sarcoidosis.
Ann NY Acad Sci, (1985),
[25.]
O.P. Sharma, D. Kadakia.
Semin Respir Med, 8 (1988), pp. 95
[26.]
D.G. James.
Definition and classification of granulomatous disorders.
Seminars in Respiratory Medicine, 8 (1986), pp. 2
[27.]
L.C. Ginns, P.D. Goldenheim, R.C. Burton, et al.
Tlymphocyte subsets in peripheral blood and lung lavage age in idiopathic pulmonary fibrosis and sarcoidosis: Analysis by monoclonal antibodies and flow cytometry.
Cli Immunol Immunopathol, 25 (1982), pp. 11
[28.]
G.W. Hunninghake, R.G. Crystal.
Pulmonary sarcoidosis: A disorder mediated by excess helper Tlymphocyte activity at sites of disease activity.
N Engl. J Med, 305 (1981), pp. 429
[29.]
B.W. Robinson, A.H. Rose, P.J. Thompson, et al.
Comparison of bronchoalveolar lavage helper/suppressor T-cell ratios in sarcoidosis versus other interstitial lung diseases.
Aust NZ J Med, 17 (1987), pp. 9
[30.]
O. Lecossier, D. Valeyre, A. Loiseau, et al.
T lymphocytes recovered by bronchoalveolar lavage from nonnal subjects and patients with sarcoidosis are refractory to proliferative signals.
Am Rev Respir Dis, 137 (1988), pp. 592
[31.]
D.A. Campbell, L.W. Poulter, R.M. Dubois.
Immunocompetent cells in bronchoalveolar lavage reflect the cell populations in transbronchial biopsies in pulmonary sarcoidosis.
Am Rev Respir Dis, 132 (1985), pp. 1300
[32.]
M.A. Spiteri, S.W. Clarke, L.W. Poulter.
Alveolar macrophages that suppress T-cell responses may be crucial to the pathogenetic outcome of pulmonary sarcoidosis.
Eur Respir J, 5 (1992), pp. 394
[33.]
H.C. Hoogsteden, J.J. Van Dongen, P.T. Van Hal, et al.
Phenotype of blood monocytes and alveolar macrop hages in interstitial lung disease.
Chest, 95 (1989), pp. 574
[34.]
K.C. Flint, K.B. Leung, B.N. Hudspith, et al.
Bronchoalveolar mast-cells in sarcoidosis: Increased numbers and accentuation of mediaior release.
Thorax, 41 (1986), pp. 94
[35.]
C. Danel, A. Dewar, B. Corrin, et al.
Ultrastructural changes in bronchoalveolar lavage cells in sarcoidosis and comparison wiih the tissue granuloma.
Am J Pathol, 112 (1983), pp. 7
[36.]
J.-M.R. Saint-Remy, D.N. Mitchell, P.J. Cole.
Variation in immunoglobulin levels and circulating immune complexes in sarcoidosis. Correlation with extent of disease and duration of symptoms.
Am Rev Respir Dis, 127 (1983), pp. 23
[37.]
P.D. Thomas, G.W. Hunnjnghake.
Current concepts of the pathogenesis of sarcoidosis.
Am Rev Respir Dis, 135 (1987), pp. 747
[38.]
P.B. Bitterman, S. Adelberg, R.G. Crystal.
Mechanism of pulmonary fibrosis: Spontaneous release of the interstitial lung disorders.
J Clin Invest, 72 (1983), pp. 1801
[39.]
Y. Martinet, W.N. Rom, G.R. Grotendorst, et al.
Exaggerated spontaneous release of platelet-derived gro wth factor by alveolar macrophages from patients with idiopathic pulmonary fibrosis.
N Engl J Med, 317 (1987), pp. 202
[40.]
A.M. Cantin, R. Boileau, R. Begin.
Increased procollagen III aminoterminal peptide-related antigens and fibro blast growth signals in in the lungs of patients with idiopathic pulmonary fibrosis.
Am Rev Resp Dis, 137 (1988), pp. 572
[41.]
N.J. Brennan, P. Crean, J.P. Long, et al.
High prevalence of familial sarcoidosis in an Irish population.
Thorax, 39 (1984), pp. 14
[43.]
D. Valeyre, P. Soler, C. Clerici, et al.
Smoking an pulmonary sarcoidosis: Effect of cigarette smoking on prevalence. clinical manifestations. alveolitis. and evoluti on of the disease.
Thorax, 43 (1988), pp. 516
[44.]
W. Ricker, M. Clark.
Sarcoidosis: A clinico-pathologic review of 300 cases, including 22 autopsies.
Am J Clin Pathol, 19 (1949), pp. 725
[45.]
K.N. Mitchell, J.G. Scadding, B.E. Heard, et al.
Sarcoidosis: Histopaihological definition and clinical diagnosis.
J ClinPathol, 30 (1977), pp. 395
[46.]
I.W. Poulter, J. Postgrad Med.
Immune aspects of sarcoidosis.
, 64 (1988), pp. 536
[47.]
Y. Rosen, S. Moon, C.-T. Huang, et al.
Granulomatous pulmonary angiitis in sarcoidosis.
Arch Pathol Lab Med, 101 (1977), pp. 170
[48.]
M.D. Rossman, R.P. Daniele, J.H. Dauber.
Nodular endobronchial sarcoidosis: a study comparing blood and lung lymphocytes.
Chest, 79 (1981), pp. 427
[49.]
O.P. Sharma, R. Johnson.
Airway obstruction in sar coidosis: a study of 123 nonsmoking American black patients with sarcoidosis.
Chest, 94 (1988), pp. 343
[50.]
C. Wollschlager, F. Khan.
Aspergillomes, compli eating sarcoidosis. A prospective study in 100 patients.
Chest, 86 (1984), pp. 585
[51.]
A.C.M. Maarsseveen, R.W. Veldhnizen, J. Stam.
A quantitative histomorphologic analysis of lymph node granulomas in sarcoidosis in relation to radiological stage I and II.
J Pathol, 134 (1983), pp. 441
[53.]
O.P. Sharma.
Sarcoidosis.
Dis Month, 36 (1990), pp. 471
[54.]
H.L. Israel, G.S. Lenchner, G.W. Atkjnson.
Sarcoidosis and aspergilloma: The role of surgery.
Chest, 82 (1982), pp. 430
[55.]
K.E. Olive, Y.P. Kataria.
Cutaneous manifestations of sarcoidosis. Relationships to other organ system involve ment. abnormal laboratory measurements, and disease course.
Arch Intern Med, 145 (1985), pp. 1811
[56.]
S. Lofgren, H. Lundback.
The bilateral hilar lymphorna syndrome. I. A study of the relations to ageand sex in 212 cases.
Acta Med Scand, 142 (1952), pp. 259
[57.]
K.J. Silverman, G.M. Hutchins, B.H. Buckley.
Cardiac Sarcoid. A clinicopathologic study of 84 unselected patients with systemic sarcoidosis.
Circulation, 58 (1978), pp. 1204
[58.]
P. Delarrey.
Neurologic manifestations in sarcoidosis. Review of the literature, with a report of 23 cases.
Ann Intern Med, 87 (1977), pp. 336
[59.]
R. Sprague, P. Harper, S. McClain, et al.
Dissemina ted gastrointestinal sarcoidosis. Case report and review of the literature.
Gastroenterology, 87 (1984), pp. 421
[61.]
V.J. Nessan, J.R. Jacoway.
Biopsy of minor salivary glands in the diagnosis of sarcoidosis.
N Engl J Med, 301 (1979), pp. 922
[62.]
O.P. Sharma, D. Raito.
Pulmonary sarcoidosis: Radiographic feature.
Clin Dermatol, 4 (1986), pp. 96
[63.]
R.H. Winterbauer, N. Belic, K.D. Moores.
A clinical interpretation of bilateral hilar adenopaihy.
Ann Intern Med, 78 (1973), pp. 65
[64.]
R.W. Spann, E.C. Rosenow, R.A. Deremee, et al.
Unilateral hilar or paratracheal adenopathy in sarcoidosis. A study of 38 cases.
Thorax, 26 (1971), pp. 296
[65.]
H.L. Israel, G. Leuchner, R.M. Steiner.
Late development of mediastinal calcification in sarcoidosis.
Am Rev Resp Dis, 124 (1981), pp. 302
[66.]
R.M. Rose, R.G. Lee, P. Costello.
Solitary nodular sarcoidosis.
Clin Radiol, 36 (1985), pp. 589
[67.]
J.J. McCort, J.A.P. Paré.
Pulmonary fibrosis and corpulmonale in sarcoidosis.
Radiology, 62 (1954), pp. 496
[68.]
D.R. Kirks, V.D. McCormick, R.H. Greenspan.
Pulmonary sarcoidosis. Roentgenologic analysis of 150 patients.
AJR, 177 (1973), pp. 777
[69.]
M.R. Littner, Achackeren, C.E. Putman, et al.
The clinical assessment of roentgenographically atypical pulmonary sarcoidosis.
Am J Med, 82 (1977), pp. 361
[70.]
H. Levy, C. Feldman, A. Wadee, et al.
Differential of sarcoidosis from tuberculosis using an enzyme linked immunosorbent assay for deJection of antibodies against Mycobacterium tuberculosis.
Chest, 94 (1988), pp. 1254
[71.]
J.W. Williams, E.R. Wallach.
Laser micropobe mass spectrometry (LAMNS) analysis of beryllium, sarcoidosis and other granulomatous diseases.
Sarcoidosis, 6 (1989), pp. 111
[72.]
D.M. Mitchell, D.N. Mitchell, J.V. Collins, et al.
Transbronchiallung biopsy through fibreoptic bronchoscope in diagnosis of sarcoidosis.
Br J Dis Chest, 74 (1980), pp. 320
[73.]
R.A. Roethe, P.B. Fuller, R.B. Byrd, et al.
Transbronchoscopic lung biopsy in sarcoidosis. Optimal number and sites for diagnosis.
Chest, 77 (1980), pp. 400
[74.]
J.R. Mikhail, D.N. Mitchell, R.A.B. Drury, et al.
A comparison of the value of mediastinal lymph node biopsy and the kveim test in sarcoidosis.
Am Rev Resp Dis, 104 (1971), pp. 544
[75.]
S. Munkgaard, F. Neukirch.
Comparison of biopsy procedures in intrathoracic sarcoidosis.
Acta Med Scand, 205 (1979), pp. 179
[76.]
G. Hillerdahl, N.K. Osterman, B. Schmekel.
Sarcoidosis: Epidemiology and diagnosis. A 15 year European study.
Am Rev Resp Dis, 130 (1984), pp. 29
[77.]
R.H. Winterbauer, S.P. Hammer.
Sarcoidosis and idiopathic pulmonary fibrosis: A review of recent events.
pp. 117-164
[78.]
E. Neville, A.N. Walker, D. Geraint-James.
Prognostic factors predicting the outcome of sarcoidosis: An analysis of 818 patients.
Q J Med, 208 (1983), pp. 525
[79.]
C.M. Sanguinethi, M. Montroni, B. Balbi, et al.
Does activity of pulmonary sarcoidosis depend on diasease duration? A corelation between bronchoalveolar lavage, scintigraphic, radiologic and physiologic parameters and time of onset of the disease.
Sarcoidosis, 4 (1987), pp. 18
[80.]
D.A. Lynch, R. Webb, G. Gamsu, et al.
Computed tomography in pulmonary sarcoidosis.
J Comput Assist Tomogr, 13 (1989), pp. 405
[81.]
M.W. Brauner, P. Grenier, D. Mompoint, et al.
Pulmonary sarcoidosis: Evaluation with high-resoluiton CT.
Radiology, 172 (1989), pp. 467
[82.]
J.R. Mathieson, J.R. Mayo, C.A. Stagles, et al.
Chronic diffuse infiltrative lung disease: Comparison of diagnostic accuracy of CT and chest radiography.
Radiology, 171 (1989), pp. 111
[83.]
D.M. Hansell.
High resolution computed tomography in sarcoidosis and extrinsic allergic alveolitis: Imaging insights.
Sarcoidosis, 9 (1992), pp. 21
[84.]
R.H. Winterbauer, J.F. Hutchinson.
Clinical significance of pulmonary function test.
Chest, 78 (1980), pp. 640
[85.]
I. Bradvik, P. Wollmer, B. Blom-Bulow, et al.
Lung mechanics and gas exchange during exercise in pulmonary sarcoidosis.
Chest, 99 (1991), pp. 572
[86.]
R.G. Benjamim, M.A. Sackner.
Pulmonary function in sarcoidosis.
Sarcoidosis, 1 (1984), pp. 50
[87.]
B.D.W. Harrison, J.M. Shaylo, T.C. Stokes.
Air flow limitation in sarcoidosis – a study of pulmonary function in 107 patients with newly diagnosed disease.
Respir Med, 85 (1991), pp. 59
[88.]
H.L. Israel, D.W. Fouts, R.A. Beggs.
A controlled trial of prednisone treatment of sarcoidosis.
Am Rev Respir Dis, 107 (1973), pp. 609
[89.]
J. Liberman.
Elevation of serum angiotensin- converting enzyme (ACE) level in sarcoidosis.
Am J Med, 59 (1975), pp. 365
[90.]
P.K. Rohatgi.
Serum angiotensin – converting enzyme in pulmonary disease.
Lung, 160 (1982), pp. 287
[91.]
A. Nosal, L.A. Schleissner, F.S. Mishkin, et al.
Angiotensin I converting enzyme and gallium scan in non invasive evaluation of sarcoidosis.
Ann Intern Med, 90 (1979), pp. 328
[92.]
J. Lieberman, F. Zakria.
Effect of captopril and enapril medication on the serum ACE test for sarcoidosis.
Sarcoidosis, 6 (1989), pp. 118
[93.]
R.P. Baugham, Y. Ploysongang, R.D. Roberts, et al.
Effects of sarcoid and steroids on angiotensin - converting enzyme.
Am Rev Respir Dis, 128 (1983), pp. 631
[95.]
B.R. Line, G.W. Hunninghake, B.A. Keogh, et al.
Gallium 67 scanning to stage the alveolitis of sarcoidosis: Correlation, with clinical studies, pulmonary function studies, and bronchoalveolar lavage.
Am Rev Respir Dis, 123 (1981), pp. 440
[96.]
D. Beaumont, J.Y. Herry, M. Sapene.
Gllium-67 in the evaluation of sarcoidosis: Correlations with serum angiotensin converting enzyme and bronchoalveolar lavage.
Thorax, 37 (1982), pp. 11
[97.]
S. Abe, M. Munakata, M. Nichimura, et al.
Gallium-67 scintigraphy, bronchoalveolar lavage, and pathologic changes in patients with pulmonary sarcoidosis.
Chest, 85 (1984), pp. 650
[98.]
D.G. James, Rizzatog, O.P. Sharma.
Bronchopulmonary lavage (BAL) – a window of the lungs.
Sarcoidosis, 9 (1992), pp. 3
[99.]
O.B. Selroos.
Value of biochemical markers in serum for determination of disease activity in sarcoidosis.
Sarcoidosis I., 45 (1984),
[100.]
P.P. Multhuswaury, V. Lopez-Majano, M. Rangin Wala, et al.
Serum angiotensin – converting enzyme (SACE) activity as an indicator of total body granuloma load and prognosis in sarcoidosis.
Sarcoidosis, 4 (1987), pp. 142
[101.]
A.F. Knipers, C. Alberts, C.M. Roos.
Standardized quantitative 67Gascintigraphy in relation to carbon monoxide diffusion capacity in pulmonary sarcoidosi.
Sarcoidosis, 10 (1993),
[102.]
R.A. Deremee, M.A. Rohrbach.
Serum angiotensinconverting enzyme in evaluating the clinical course of sarcoidosis.
Ann Intern Med, 92 (1980), pp. 361
[103.]
B.A. Keogh, G.W. Hunninghake, B.R. Line, et al.
Therapy decisions in sarcoidosis: prospective use ofbronchoalveolar lavage and gallium-67 scanning.
Am Rev Respir Dis, 121 (1980), pp. 155
[104.]
R.G. Crystal, W.C. Roberts, W. Hunninghakeg, et al.
Pulmonary sarcoidosis: a disease characterised and perpetuated by activated lung T lymphocytes: NIH Conference.
Ann Intern Med, 94 (1981), pp. 73
[105.]
M.M. Muthiah, J.T. Macfarlane.
Current concepts in the management of sarcoidosis.
Drugs, 40 (1990), pp. 231
[106.]
M. Turner-Warwick, P.L. Haslam, W. McAllister, et al.
Do measurements of zyme and gallium uptake help the clinician to treat patients with sarcoidosis?.
[107.]
S.H. Kirtland, R.H. Winterbauer.
Pulmonary sarcoidosis.
Semin Respir Med, 14 (1993), pp. 344
[108.]
G. Rizzato, A. Blasi, C. Alberts.
An european survey on 67Ga lung scan in sarcoidosis.
pp. 111-126
[109.]
J. Lieberman, L. Schleissner, A. Nosal.
Clinical correlation of serum angiotensin-converting enzyme (ACE) in sarcoidosis. A longitudinal study of serum ACE. 67 Galium scans chest roentgenograms, and pulmonary function.
Chest, 84 (1983), pp. 522
[110.]
P. Rohatgi, H. Baier.
Quantitative gallium scanning in pulmonary sarcoidosis.
Respiration, 44 (1983), pp. 304
[111.]
O.P. Sharma.
Pulmonary sarcoidosis and corticosteroids.
Am Rev. Respir Dis, 147 (1993), pp. 1598
[112.]
G. Bisson, G. Drapeau, G. Lamoureaux, et al.
Computer-based quantitative analysis of Gallium67 uptake in normal and diseased lungs.
Chest, 84 (1983), pp. 513
[113.]
C.S. Bergin, D.Y. Bell, C.L. Coblentz, et al.
Sarcoidosis: correlation of pulmonary parenchymal pattern at CT with results of pulmonary functiontests.
Radiology, 171 (1989), pp. 619
[114.]
C.M. Odlum, M.X. Fritzgerald.
Evidence that steroids alter the natural history of previously progressive pulmonary sarcoidosis.
Sarcoidosis, 3 (1986), pp. 40
[115.]
D. Zych, W. Krychniak, L. Pawlicka, et al.
Sarcoidosis of the lung. Natural history and effects of treatment.
Sarcioidosis, 4 (1987), pp. 64
[116.]
L.E. Siltzbach.
Effects of cortisone in sarcoidosis: a study of thirteen patients.
Am J Med, 12 (1952), pp. 139
[117.]
D.G. James, L.S. Carstairs, J. Trowell, et al.
Treatment of sarcoidosis: report of a controlled therapeutic trial.
Lancet, 2 (1967), pp. 526
[118.]
M. Yamamoto, N. Saito.
Effect of 18 month corticosteroid therapy on the stage I and II sarcoidosis patients.
Ann NY Acad Sci, 278 (1976), pp. 7220
[119.]
F.K. Romer.
Presentation of sarcoidosis and outcome of pulmonary changes.
Dan Med Bull, 29 (1982), pp. 27
[120.]
C.J. Johns, J.B. Zachary, W.C. Ball.
A ten-year study of corticosteroid treatment of pulmonary sarcoidosis.
Johns Hopkins Med J, 134 (1974), pp. 271
[121.]
C.J. Johns, S.A. Schonfeld, P.P. Scott, et al.
Longitudinal study of chronic sarcoidosis with low-dose maintenance corticosteroid therapy.
Ann NY Acad Sci, 465 (1986), pp. 702
[122.]
D. Valeyre.
Sarcoidose: diagnostic, évaluation. traitment.
Rev Prat (Paris), 43 (1993), pp. 1167
[123.]
L. Spratling, M.F. Tenholder, G.H. Underwood, et al.
Daily vs alternate day prednisone therapy for stage II sarcoidosis.
Chest, 88 (1985), pp. 687
[124.]
E.E. Lower, R.P. Baughman.
The use of low dose methotrexate in refractory sarcoidosis.
Am J Med Sci, 299 (1990), pp. 153
[125.]
R.P. Baughman, E.E. Lower.
The effect of corticosteroid or methotrexate therapy on lung lymphocytes and macrophages in sarcoidosis.
Am Rev Respir Dis, 142 (1990), pp. 126
[127.]
H.L. Israel, B.L. Mccomb.
Chlorambucil treatment of sarcoidosis.
Sarcoidosis, 8 (1991), pp. 35
[128.]
Y. Martinet, P. Pinkston, C. Saltini, et al.
Evaluation of the in vitro and in vivo effects of cyclosporine on the lung T-lymphocyte alveolitis of active pulmonary sarcoidosis.
Am Rev Respir Dis, 138 (1988), pp. 1242
[129.]
O.B. Selroos.
Inhaled corticosteroids and pulmonary sarcoidosis.
Sarcoidosis, 5 (1988), pp. 104
[130.]
H.M. Brown, G. Storey, W.H.S. George.
Beclomethasone dipropionate: a new steroid aerosol for the treatment of allergic asthma.
Br Med J, 4 (1972), pp. 585
[131.]
M.F. Hodson, I.C. Batten, S. Cark, et al.
Belclomethasone dipropionate aerosol in asthma; transfer of steroiddependent asthmatic from oral prednisolone to beclomethasone dipropionate aerosol.
Am Rev Respir Dis, 110 (1974), pp. 403
[132.]
Ch.E. Reed.
Aerosol glucocorticoid treatment of asthma.
Am Rev Respir Dias, 141 (1990), pp. S82-S88
[133.]
E.F. Juniper, P.A. Kline, M.A. Vanzieleghem, et al.
Long-term effects of budesonide on airway responsiveness and clinical asthma severity in inhaled steroid-dependent asthmatics.
Eur Resp J, 3 (1990), pp. 1122
[134.]
S.K. Gupta.
Treatment of sarcoidosis patients by steroid aerosol: A ten-year prospective study from Eastern India.
Sarcoidosis, 6 (1989), pp. 51
[135.]
D. Zych, L. Pawlicka, J. Zielinski.
Inhaled budesonide vs prednisone in the maintenance treatment of pulmonary sarcoidosis.
Sarcoidosis, 10 (1993), pp. 56
[136.]
O. Selroos.
Use of budesonide in the treatment of pulmonary sarcoidosis.
Ann N Y Acad Sci, 485 (1986), pp. 713
[137.]
A.D. Morgan, A.M. Johnson, I. Kerr, et al.
The action of an inhaled corticosteroid as a steroid sparing agentin chronic pulmonary sarcoidosis.
Am Rev Respir Dis, 135 (1987), pp. A349
[138.]
O. Selroos.
Further experiences with inhaled budesonide in the treatment of pulmonary sarcoidosis.
pp. 637-640
[139.]
W. Petermann, P. Entzian, J. Barth.
BAL and Lung Function Tests in steroid-treated patients with sarcoidosis – Comparison between oral and inhalative administration of steroids.
Eur Respir J, 1 (1988), pp. 259
[140.]
R.C. Young, G.K. Sahetya, S.N. Hassan, et al.
Chronic airways obstruction in pulmonary sarcoidosis: its poor response to bronchodilators.
J Natl Med Assoc, 72 (1980), pp. 965
[141.]
P. Andersson, A. Ryrfeldt.
Biotransformation of the topical glucocorticosteroids budesonide and beclomethasone 17α, 21-dipropionate in human liver and lung homogenate.
J Pharm Pharmacol, 36 (1984), pp. 763
[142.]
M.A. Spiteri, S.P. Newman, S.W. Clarke, et al.
Inhaled corticosteroids can modulate the irnrnunopathogenesis of pulmonary sarcoidosis.
Eur Respir J, 2 (1989), pp. 218
[143.]
P. Anderson, S. Edsbacker, A. Ryrfeldt.
In vitro biotransformation of glucocorticoids in liver and skin homogenate fractions from man, rat and hairless mouse.
J Steroid Biochem, 16 (1982), pp. 787
[144.]
A.J. Williams, M.S. Maghat, D.E. Stableforth, et al.
Dysphonia caused by inhaled steroids: Recognition of a characteristic laryngeol abnormality.
Thorax, 38 (1983), pp. 813
[145.]
J.H. Toogood, J. Baskerville, B. Jennings, et al.
Use of spacers to taciliate inhaled corticosteroid treatment of asthma.
Am Rev Respir Dis, 129 (1984), pp. 723
[146.]
S.P. Newman, A.B. Miller, T.R. Lennard-Jones, et al.
Improvement of pressurized aerosol deposition with nebuhaler spacer device.
Thorax, 39 (1984), pp. 935
[147.]
J.H. Toogood, J. Baskerville, B. Jennings, et al.
Influence of dosing frequency and schedule on the response of chronic asthmatics to the aerosol steroid, budesonide.
J Allergy Clin Immunol, 70 (1982), pp. 288
[148.]
B.W. Levine, M. Saldena, A.M. Hutter.
Pulmonary hypertension in sarcoidosis.
Am Rev Respir Dis, 103 (1971), pp. 413
[149.]
A.S. Rebuck, B.R. Saunders, G.K. Mcfadden, et al.
Cyclosporine in pulmonary sarcoidosis.
Lancet, 1 (1987), pp. 1486
[150.]
British Tuberculosis Association.
Chloroquine in treatment of sarcoidosis.
Tubercl, 54 (1973), pp. 87
[151.]
M.J. Lacher.
Spontaneous remission or response to methotrexate in sarcoidosis.
Am Intern Med, 69 (1986), pp. 12478
[152.]
Sharma O, Hughes DTD, James DG et al. Immunosuppressive therapy with Azathioprine in Sarcoidosis. In Proc 5th International Conference on Sarcoidosis. Prague. L. Levinsky, F. Macholda Univ Karlova, Prague, 635–637.
[153.]
J. Scott, T. Higenbottam.
Transplantation of the lungs and heart and lung for patients with severe pulmonary complications from sarcoidosis.
Sarcoidosis, 7 (1990), pp. 9
[154.]
B.A. Reitz, N.A. Burton, S.W. Jamieson, et al.
Heart and lung transplantation: Auto & Allotransplantation in primates with extended survival.
J Thorac Cardiovasc Surg, 80 (1980), pp. 360
[155.]
B.A. Reitz, J. Wallwork, S.A. Hunt, et al.
Heart-lung Transplantation: a sucessful therapy for patients with pulmonary vascular disease.
N Engl J Med, 306 (1982), pp. 557
[156.]
J.A. Hutter, P. Despins, T.W. Higenbottam, et al.
Heart-Lung transplantation: better use of resources.
Am J Med, 4 (1988), pp. 11
[157.]
J. Wallwork, K. Jones, N. Cavarocchi, et al.
Distant procurement of organs for clinical Heart-Lung Transplantation using a single flush technique.
Transplantation, 44 (1987), pp. 654
[158.]
J.A. Hutter, J.P. Scott, T. Wreghitt, et al.
The importance of cytomegalovirus in Heart-Lung Transplant recipients.
Chest, 95 (1989), pp. 627
[159.]
T. Higenbottam.
pp. 533-544
[160.]
B.P. Griffith, I.L. Paradis, A. Zeevi, et al.
Immunologically mediated disease of the airways after pulmonary transplantation.
Ann Surg, 208 (1988), pp. 371
[161.]
S.A. Yousem, K.M. Burke, M.E. Billingham.
Pathological pulmonary alterations in longterm human Heart Lung Transplantation.
Hum Pathol, 16 (1985), pp. 911
[162.]
J.P. Scott, T.W. Higenbottam, C. Clelland, et al.
The natural history of obliterative bronchiolitis and occlusive vascular disease in patients following Heart-lung Transplantation.
Trans Proc, 21 (1989), pp. 2592
[163.]
D.T.C. Cooper, O. Novitzky, A.G. Rose, et al.
Acute pulmonary rejection precedes cardiac rejection following Heart-Lung Transplantation in the primate model.
J Hearth Transplant, 5 (1986), pp. 29
[164.]
T.W. Higenbottam, S. Stewart, J. Wallwork.
Transbronchial lung biopsy to diagnose rejection and infection in Heart-lung Transplant.
Trans Proc, 20 (1988), pp. 767
[165.]
B. Millet, T.W. Higenbottam, C.D.R. Flower, et al.
The radiographic appearances of infection and acute rejec tion of the lung after Heart-Lung Transplantation.
Am Rev Respir Dis, 140 (1989), pp. 62
[167.]
V. Pacheco, C. Marechal, F. Marechal, et al.
Azathioprine treatment of chronic pulmonary sarcoidosis.
Sarcoidosis, 2 (1985), pp. 107
[168.]
A.S. Rebuk, C.R. Stiller, A.C. Braude, et al.
Cyclosporine tor pulmonary sarcoidosis.
Lancet, 1 (1984), pp. 1174
[169.]
E.L. York, T. Kovithavongs, S.F. Man, et al.
Cyclosporine and chronic sarcoidosis.
Chest, 98 (1990), pp. 1026
[170.]
G. Rizzato, P. Fraioli, L. Montemurro.
Long-term therapy with deflazacort in chronic sarcoidosis.
Chest, 99 (1991), pp. 301
[171.]
A. Karma.
Ocular sarcoidosis.
Semin Respir Med, 13 (1992), pp. 425
[172.]
R.B. Nussenblatt, A.G. Palestine.
Sarcoidosis.
pp. 198-211
[173.]
L. Bielory, L.P. Frohman.
Low-dose cyclosporine therapy of granulomatous optic neuropathy and orbito-pathy.
Ophthalmology, 98 (1991), pp. 1732
[174.]
P. Leong, L.L. Hart.
lmmunosuppressives in sarcoidosis.
Drug Int Clin Pharm, 19 (1985), pp. 909
[175.]
D.G. James.
Sarcoidosis of the skin.
Semin Respir Med, 13 (1992), pp. 432
[176.]
E. Jones, J.P. Callen.
Hydroxychloroquine is effective therapy for control of cutaneous sarcoidal granulomas.
J Am Acad Dermatol, 23 (1990), pp. 487
[177.]
J.A. Zic, D.H. Horowitz, C. Arzubiaja, et al.
Treatment of cutaneous sarcoidosis with cloroquine. Review of the llterature.
Arch Dermatol, 127 (1991), pp. 1043
[178.]
G.F. Webster, L.K. Razsi, M. Sanchez, et al.
Weekly low-dose methotrexate therapy for cutaneous sarcoidosis.
J Am Acad Dermatol, 24 (1991), pp. 451
[179.]
O.P. Sharma, A. Maheshwari, K. Thaker.
Miocardial sarcoidosis.
Chest, 103 (1993), pp. 253
[180.]
T. Ishikawa, H. Kondoh, S. Nakagaura, et al.
Steroid therapy in cardiac sarcoidosis.
Chest, 85 (1984), pp. 445
[181.]
S.L. Demeter.
Myocardial sarcoidosis unresponsive to steroids. Treatment with cyclophosphamide.
Chest, 94 (1988), pp. 202
[182.]
H. Schaedel, D. Kirsten, A. Schmidt, et al.
Sarcoid heart disease – results of follow-up investigations.
Eur Heart J, 12 (1991), pp. 26
[183.]
V. Oksanen.
Neurosarcoidosis.
Semin Respir Med, 13 (1992), pp. 459
[184.]
R.K.A. Allen, J. Merory.
Intravenous pulse methylprednisolone in the successful treatment of severe sarcoid poly-neuropathy with pulmonary involvement.
Aust NZ J Med, 15 (1985), pp. 45
[185.]
D.G. James.
Sarcoidosis.
Postgrad J Med, 60 (1984), pp. 234
[186.]
F.G. Soriano, P. Caramelli, R. Nitrini, et al.
Neurosarcoidosis: Therapeutic success with methotrexate.
Postgrad Med J, 66 (1990), pp. 142
[187.]
B.J. Stern, S.A. Schonfeld, C. Sewell, et al.
The treatment of neurosarcoidosis with cyclosporine.
Arch Neurol, 49 (1992), pp. 1065
[188.]
J.M. Bejar, G.R. Kerby, O.K. Ziegler, et al.
Treatment of central nervous system sarcoidosis with radiotherapy.
Ann Neurol, 18 (1985), pp. 258
[189.]
R.S. Muther, D.A. Mccarron, W.M. Bennett.
Granulomatous sarcoid nephritis: a cause of multiple renal tubular abnormalities.
Clinical Nephrology, 14 (1980), pp. 190
[190.]
A.M. Sharma, J. Kadakia, O.P. Sharma.
Gastrointestinal sarcoidosis.
Semin Respir Med, 13 (1992), pp. 442
[191.]
S. Sherlock.
The liver in sarcoidosis.
Semin Respir Med, 13 (1992), pp. 450
[192.]
C.F. Mellissant, S.J. Smith, B.A. Kazzaz, et al.
Bleeding varices due to portal hypertension in sarcoidosis favorable effect of propranolol and prednisone.
Chest, 103 (1993), pp. 628
[193.]
P.K. Rohatgi.
Osseous sarcoidosis.
Semin Respir Dis, 13 (1992), pp. 468
[194.]
F.A. Engle, O.F. Cooney.
Tetraplegia secondary to sarcoidosis Case report.
J Neurosurg, 50 (1979), pp. 665
[195.]
W.B. Guilford, W.M. Mentz, H.A. Kopelman, et al.
Sarcoidosis presenting as a rib fracture.
AJR, 139 (1982), pp. 608
[196.]
N.T. Soskel, O.P. Sharma.
Pleural involvement in sarcoidosis.
Semin Respir Med, 13 (1992), pp. 492
[197.]
S.J. Brete, M.A. Pfotenhauer.
Massive pleural effusion in sarcoidosis.
Am Rev Respir Dis, 86 (1962), pp. 261
[198.]
T.J. O’ Leary, G. Hones, A. Yip.
The effects of chloroquine serum 1, 25-dihydroxy vitamin D and calcium metabolism in sarcoidosis.
N Engl J Med, 315 (1986), pp. 727
[199.]
J.S. Adams, M.M. Diz, O.P. Sharma.
Effective reduction in the serum 1.25 dihydroxyvitamin D and calcium concentration in sarcoidosis associated hypercalcemia with short course chloroquine therapy.
Ann Intern Med, III (1989), pp. 437
[200.]
J.S. Adams, O.P. Sharma, M.M. Diz.
Kectonazole decreases the serum 1.25-dihydroxyvitamin D and calcium concentration in sarcoidosis – associated hypercalcemia.
J Clin Endocrinol Metab, 70 (1990), pp. 1090
[201.]
M.J. Bia, K. Insogna.
Treatment of sarcoidosis associated hypercalcemia with ketoconazole.
Am J Kidney Dis, 18 (1991), pp. 702
[202.]
C.J. Johns.
The prognosis and management of sarcoidosis.
Mt Sinai J Med, 44 (1977), pp. 782
[203.]
J. Mañá, F. Badrinas.
Prognosis of sarcoidosis an unresolved issue.
Sarcoidosis, 9 (1992), pp. 15
[204.]
K. Takada, Y. Ina, M. Noda.
The clinical course and prognosis of patients with severe, moderate or mild sarcoidosis.
J Clin Epidemiol, 146 (1993), pp. 359
[205.]
D.G. James, W.J. Williams.
WB Saunders Company, (1985), pp. 38-48
[206.]
H.L. Israel, P. Karlin, H. Menduke, et al.
Outcome of sarcoidosis related to race, extrathoracicinvolvement and initial roentgenographic lesions.
Ann NY Acad Sci, 465 (1986), pp. 609
[207.]
G. Hillerdal, E. Nou, K. Osterman, et al.
Sarcoidosis: epidemiology and prognosis. A 15-year European study.
Am Rev Respir Dis, 130 (1984), pp. 29
[208.]
J.M. Reich, R.E. Johnson.
Course and prognosis of sarcoidosis in a nonreferral serring. Analysis of 86 patients observed for 10 years.
Am J Med, 78 (1985), pp. 61
[209.]
J.M. Cumminskey.
Pulmonary function testing in sarcoidiosis.
Sarcoidosis, pp. 137-144
[210.]
M. Thunell, N. Stjernberg, L. Rosenhall, et al.
Pulmonary function in patients with sarcoidosis.
Sarcoido sis, 4 (1987), pp. 129
[211.]
E. Ueda, T. Kawabe, T. Tachibana, et al.
Serum angiotensin converting enzyme activity as an indicator of prognosis is sarcoidosis.
Am Rev Respir Dis, 121 (1980), pp. 667
[212.]
F.K. Romer.
The level of angiotensin-converting enzyme as indicator of 2 year prognosis in untreated pulmonary sarcoidosis without erythema nodosum.
Acta Med Scand, 211 (1982), pp. 293
[213.]
M. Rust, L. Bergman, T. Kuhn, et al.
Prognostic value of chest radiograph, serum angiotensin-converting enzyme and T helper cell count in blood and bronchoalveolar lavage of patients with pulmonary sarcoidosis.
Respiration, 48 (1985), pp. 231
[214.]
D. Choudat, L.G.M. Stanilas, D.M.S. Mordelet, et al.
Serum activity of angiotensin converting enzyme and pulmonary radiograph as prognostic criteria in sarcoidosis.
Eur J Respir Dis, 64 (1983), pp. 355
[215.]
A.H. Niden, F.S. Mishkin, F. Salem, et al.
Prognostic stgnificance of Gallium lung scan in sarcoidosis.
Ann NY Acad Sci, 465 (1986), pp. 435
[216.]
K. Ward, C. O’Connor, C. Odlum, et al.
Prognostic value of bronchoalveolar lavage in sarcoidosis: The critical influence of disease presentation.
Thorax, 44 (1989), pp. 6
[217.]
A. Verstracten, M. Demedts, J. Verwilghen, et al.
Predictive value of bronchoalveolar lavage in pulmonary sarcoidosis.
Chest, 98 (1990), pp. 560
[218.]
O. Selroos.
Bronchoalveolar lavage and biochemical markers in serum pos monitoring disease activity and prognosis of sarcoidosis.
Sarcoidosis, 9 (1992), pp. 145
[219.]
B.D. Israel, A. Venet, J. Chrétien.
Persistent high alveolar lymphocytosis as a predictive criterion of chronic pulmonary sarcoidosis.
Ann NY Acad Sci, 465 (1986), pp. 395
[220.]
L. Bjemer, L. Rosenhall, T. Angstrom, et al.
Predictive value of bronchoalveolar lavage cell analysis in sarcoidosis.
Thorax, 43 (1988), pp. 284
[221.]
U. Costabel, K.J. Bross, J. Guzman, et al.
Predictive value of bronchoalveolar T cell subsets for the course of pulmonary sarcoidosis.
Am NY Acad Sci, 465 (1986), pp. 418
[222.]
M. Turner-Warwick, P.L. Haslem, W. McAllister, et al.
Do measurements of bronchoalveolar lymphocytes and neutrophils. serum angiotensin-converting enzyme and gallium uptake help the clinician to treat patients with sarcoidosis?.
Ann NY Acad Sci, 465 (1986), pp. 387
[223.]
G.W. Státon, M.J. Gilman, J.R. Pine.
Comparison of clinical parameters. bronchoalveolar lavage. gallium 67 lung uptake and serum angiotensin converting enzymt: in assessing the activity of sarcoidosis.
Sarcoidosis, 3 (1986), pp. 10
[224.]
M. Laviolette, J. La Forge, S. Tennina, et al.
Prognostic value of bronchoalveolar lavage lymphocyte count in recently diagnosed pulmonary sarcoidosis.
Chest, 100 (1991), pp. 380
[225.]
H. Eule, A. Weinecke, I. Roth.
The possible influence: of corticosteroid therapy on the natural course of pulmonary sarcoidosis.
Ann NY Acad Sci, 465 (1986), pp. 695
[226.]
M.H. Zaki, H.A. Lyons, L. Leiloj, et al.
Corticosteroid therapy in sarcoidosis.
SH J Med, 87 (1987), pp. 487
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