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Prognostic features of sarcoidosis course in a Brazilian cohort

Authors
  • Castro, Marina Dornfeld Cunha
  • Pereira, Carlos Alberto de Castro
  • Soares, Maria Raquel
Type
Published Article
Journal
Jornal Brasileiro de Pneumologia
Publisher
Sociedade Brasileira de Pneumologia e Tisiologia
Publication Date
Jan 24, 2022
Volume
48
Issue
1
Identifiers
DOI: 10.36416/1806-3756/e20210366
PMID: 35137872
PMCID: PMC8836631
Source
PubMed Central
Keywords
Disciplines
  • Original Article
License
Unknown

Abstract

Objective: To identify predictive features associated with the course of sarcoidosis at initial evaluation and to develop a predictive score. Methods: This was a retrospective study involving pulmonary sarcoidosis patients, classified as having a self-limited or persistent course of disease, comparing data between the outcomes by univariate analysis. Features related to persistent disease were selected by multivariate analysis and a prognostic score was designed. Results: The sample comprised 200 patients (mean age = 49 years). The median duration of symptoms to diagnosis was 12 months, and delayed diagnosis (> 12 months) was found in 43% of the cases. The most common radiological stage was II; 37% had reduced FVC. Relevant systemic involvement was detected in 37% of the patients. Treatment for tuberculosis was prescribed in 44 patients prior to sarcoidosis diagnosis. Treatment for sarcoidosis was required in 77% of the sample, and the disease course was persistent in 115 cases. Excluding 40 patients with fibrotic disease, prognostic factors to persistent disease were parenchymal involvement, delayed diagnosis, dyspnea, relevant systemic involvement, and reduced FVC. On the basis of the analysis, a 3-letter scoring system (A, B and C) was developed according to the selected factors. The positive predictive values for persistent course for A (≤ 1 point) and C scores (≥ 4 points) were 12.5% and 81.8%, respectively. Conclusions: A score can be derived by selected features at initial evaluation, allowing the prediction of outcomes in a significant number of sarcoidosis patients.

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