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A1520 - Clinical Characteristics of Pulmonary Sarcoidosis Requiring Systemic Corticosteroids
Author Block: H. Kimura1, S. Konno1, T. Yamaguchi2, N. Shijubo3, T. Hattori4, Y. Yamada5, K. Shimizu1, M. Suzuki1, M. Nishimura1; 1Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan, 2Shinjuku-Kaijo Building Clinic, Tokyo, Japan, 3Department of Respiratory Medicine, JR Sapporo Hospital, Sapporo, Japan, 4Department of Respiratory Medicine, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan, 5Department of Chest Medicine, Japan Railway Tokyo General Hospital, Tokyo, Japan.
Rationale: The clinical course of pulmonary sarcoidosis, which is characterized by lesions of the lung parenchyma and enlargement of the hilar and/or mediastinal lymph nodes, is highly variable; some patients can remit spontaneously, while other patients have to receive systemic corticosteroids because of exacerbation of the disease. Since, there have been few reports clarifying the clinical characteristics of patients with pulmonary sarcoidosis requiring systemic corticosteroids, this was the aim of the current study. Methods: Sixty-seven patients with pulmonary sarcoidosis currently taking or who have taken systemic corticosteroids at the Hokkaido University Hospital (N=11), JR Sapporo Hospital (N=26) and Shinjuku-Kaijo Building Clinic (N=30), were included in this study. Clinical characteristics of these subjects, including age at diagnosis of sarcoidosis, gender differences, duration of the systemic corticosteroid after the initial diagnosis, and prevalence of other organs involved, were retrospectively evaluated. Results: The median age of diagnosis of sarcoidosis was 35 (interquartile range: 26-47.5) years. Thirty-four patients were male and 33 were female. The median interval from initial diagnosis to starting systemic corticosteroids was 6 (interquartile range: 1-9.8) years. Fourteen subjects (20.9%) could terminate the systemic corticosteroids, while 53 subjects (79.1%) could not, due to the confirmation of an increase in the disease activity after tapering steroids. The prevalence of cardiac lesions was significantly higher in subjects who were able to quit steroids as compared to those who could not (28.6% vs 5.7%, P=0.013). Conclusion: The wide distribution of the periods after initial diagnosis of sarcoidosis until starting systemic corticosteroids was observed, suggesting the heterogenous clinical course of pulmonary sarcoidosis. The timing of indication of systemic steroids was dependent on the individual clinical course of pulmonary sarcoidosis.