SARCOIDOSIS- A CLINICORADIOLOGICAL PROFILE OF 30 PATIENTS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 45
Abstract
BACKGROUND Sarcoidosis is an inflammatory multisystem granulomatous disease of unknown aetiology and predominantly affects the lungs, followed by eye, skin, peripheral lymph node, liver, spleen, heart, central nervous system, musculoskeletal system and salivary glands. Aim- To find out the clinical profile of sarcoidosis patients prospectively admitted to a respiratory unit. MATERIALS AND METHODS The study was conducted on 30 patients of sarcoidosis, who were admitted for various respiratory complaints, in the Department of Pulmonary Medicine, GSVM Medical College, Kanpur & Govt. Medical College, Kannauj. A thorough respiratory evaluation was done including clinical evaluation for signs and symptoms, chest x-ray PA view, HRCT Thorax, Spirometry, sputum for AFB, PPD, serum ACE, serum Calcium, 24-hour urinary calcium, BAL Fluid analysis, CD4 to CD8 of BAL fluid. RESULTS 30 patients of sarcoidosis were evaluated. Of the total patients, male & female were 11 and 19 respectively and ratio was 1:1.7. The mean age of study group was 34.8 years (Range 27-51). Dyspnoea was present in all the patients followed by dry cough (93.3%). Bilateral hilar lymphadenopathy plus pulmonary opacity was the most common radiological presentation of sarcoidosis in 14/30 (46.7%). Pleural effusion was noted in a single case. Extrapulmonary manifestations like subcutaneous nodules were seen in only one case while uveitis also observed in single case only. Sputum for AFB was negative in 2 cases, while others did not raise sputum. PPD testing showed no induration among all, except one where it showed mild induration (6 mm). Serum ACE was elevated in 24/30 patients (86.6%). Serum Calcium was elevated in 10/30 patients (28.6%). 24-hour urinary calcium was elevated in 8/30 patients (26.6%). Spirometry showed a restrictive pattern in 71.4% (i.e. 20/28) and was normal in 17.9% cases while the other three patients did not cooperate. The CD4 to CD8 of BAL fluid levels were raised in all cases of sarcoidosis (range 2.9- 4.4). CONCLUSION Bilateral hilar lymphadenopathy plus pulmonary opacity was the most common radiological presentation of sarcoidosis and BAL fluid CD4 to CD8 counts are easy to perform and helpful in supporting diagnosis of sarcoidosis along with clinical and radiological features.
Authors and Affiliations
Avdhesh Kumar, Brijesh Kumar, Anand Kumar, Sanjay Kumar Verma, Sanjeev Rohtagi, Anshul Jain, Sudhir Chaudhri, Surya Kant
Keywords
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- EP ID EP216810
- DOI 10.14260/Jemds/2017/757
- Views 62
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