The Course of Pulmonary Function in Sarcoidosis

Abstract

Serial studies of pulmonary function were done in 18 patients with sarcoidosis over an average period of 41 months. The patients were classified on the basis of their initial x-ray picture as hilar adenopathy, disseminated nodular densities, confluent infiltrates and "fibrosis." Symptoms and functional abnormalities increased in severity from group to group in the order named with, however, considerable variation within the groups. Despite usual radiologic and clinical improvements in 5 patients with hilar adenopathy, none had improvement of function and 4 had a decrease in diffusing capacity. The 4 patients with confluent infiltrates had less symptomatic improvement and more striking radiographic residua than the 6 patients with disseminated nodular densities. Functional changes, though more severe in the patients with confluent disease, followed a similar pattern: 9 of these patients had decreased lung volumes, low compliance and low diffusing capacity. Lung volumes increased in 7, compliance increased in 6, but diffusing capacity rose only in 3 and became normal in only 2 of these, both having initially disseminated nodular disease. Of 3 patients with "fibrosis", 2 had a combination of low lung volumes, decreased diffusion and airway obstruction which did not improve or grow worse. Steroids were used in 14 patients with limited effects on either diffusion or established airway obstruction. It was concluded that pulmonary sarcoid commonly leaves an impaired diffusion despite symptomatic and radiological improvement and increases in lung volumes and compliance.