Radiological predictive remission factors of pulmonary involvement in systemic sarcoidosis: a computed tomography scan study Remission factors of pulmonary sarcoidosis
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Keywords
Pulmonary manifestations, Computed tomography scan, Sarcoidosis
Abstract
Introduction: As little is known about the prognostic value of CT scan findings at onset in patients presenting with sarcoidosis, we aimed to identify factors independently associated with radiological remission of pulmonary involvement in systemic sarcoidosis on CT scan findings.
Methods: We conducted a retrospective descriptive and analytic study of patients with a biopsy proven systemic sarcoidosis. We compared patients on radiological remission (group 1) to those on stabilization or progression (group 2). Multivariate analysis of variables significantly associated with radiological remission in univariate analysis was performed using binary logistic regression.
Results: Out of 65 records of systemic sarcoidosis, 43 were analyzed. 18.6% where male and 81.6% female with a sex-ratio of 0.22 and a mean age at diagnosis of 47.2 ±13.6 years. We found atypical lesions in CT scan findings in 16 patients (37.2%). Comparative pulmonary CT scan findings at admission and at 12 months follow-up revealed 13 patients (30.2%) in remission (group1) and 30 patients in radiological stabilization or progression (group 2). On multivariate analysis, lymphopenia, calcifications, and typical CT scan findings at presentation were predictive factors of remission of pulmonary involvement in systemic sarcoidosis (aOR=27.57; 95%IC=2.67-284.63; p=0.005) (aOR= 37.2; 95%IC= 2.08-663.89; p= 0.014) (aOR=47.1; 95%IC= 1.79-1238.7; p=0.021) respectively.
Conclusion: In patients with systemic sarcoidosis with no lymphopenia at onset or calcifications or typical CT scan findings at presentation, we suggest a close follow-up as well as an intensive treatment
References
2- Miller BH, Rosado-de-Christenson ML, McAdams HP, Fishback NF (1995) Thoracic sarcoidosis: radiologic-pathologic correlation. Radiographics 1995 Mar;15(2):421-37.
3- Fazzi P. Pharmacotherapeutic management of pulmonary sarcoidosis. Am J Respir Med 2003;2(4):311-20.
4- Hostettler KE, Studler U, Tamm M, et al. Long-term treatment with infliximab in patients with sarcoidosis. Respiration 2012;83(3):218-24
5- Augier A, Brillet PY, Duperon F, Nunes H, Valeyre D, Brauner M. Analyse en tomodensitometrie de 500 cas de sarcoidose pulmonaire. J Radiol 2005;86(10):1385.
6- Fabry A, Cohen JG, Reymond E, Jankowski A, Ferretti G. Verre dépoli pulmonaire en tomodensitométrie thoracique. J Imag Diagn Interv 2018;1(2):102‑5.
7- Calandriello L, Walsh SLF. Imaging for Sarcoidosis. Semin Respir Crit Care Med 2017 Aug;38(4):417-436.
8- Polverosi R, Russo R, Coran A, et al. Typical and atypical pattern of pulmonary sarcoidosis at high-resolution CT: relation to clinical evolution and therapeutic procedures. Radiol Med 2014 Jun;119(6):384-92
9- Susam S, Ucsular FD, Yalniz E, et al. Comparison of typical and atypical computed tomography patterns regarding reversibility and fibrosis in pulmonary sarcoidosis. Ann Thorac Med 2021 Jan-Mar;16(1):118-125
10- Criado E, Sánchez M, Ramírez J, et al. Pulmonary Sarcoidosis: Typical and Atypical Manifestations at High-Resolution CT with Pathologic Correlation. Radiographics 2010 Oct;30(6):1567-86
11- Sharma SK, Soneja M, Sharma A, Sharma MC, Hari S. Rare manifestations of sarcoidosis in modern era of new diagnostic tools. Indian J Med Res May 2012;135(5):621‑9.
12- Reichel H, Koeffler HP, Barbers R, Norman AW. Regulation of 1,25-dihydroxyvitamin D3 production by cultured alveolar macrophages from normal human donors and from patients with pulmonary sarcoidosis. J Clin Endocrinol Metab 1987; 65: 1201–1209.
13- Vagts C, Ascoli C, Fraidenburg DR, et al. Unsupervised Clustering Reveals Sarcoidosis Phenotypes Marked by a Reduction in Lymphocytes Relate to Increased Inflammatory Activity on 18FDG-PET/CT. Front Med 2021; 8: 595077
14- El Jammal T, Dhelft F, Pradat P, et al. Diagnostic value of elevated serum angiotensin-converting enzyme and lymphopenia in patients with granulomatous hepatitis. Sarcoidosis Vasc Diffuse Lung Dis 2023;40(3):e2023031
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