Zurkova Monika, Kolek Vitezslav, Tomankova Tereza, Kriegova Eva
Department of Respiratory Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014 Dec;158(4):613-20. doi: 10.5507/bp.2014.026. Epub 2014 Jun 25.
Patients with pulmonary and pulmonary plus extrapulmonary sarcoidosis differ in symptom severity and health status impairment. To date there is no information on differences in clinical and laboratory parameters between these phenotypes and limited information on extrapulmonary involvement in Czech sarcoidosis patients exists.
We therefore compared clinical data (age, gender, organ involvement, lung function tests) and laboratory data (blood counts, bronchoalveolar fluid (BAL) cellular profile, serum levels of CRP, SACE, sIL-2R, neopterin) between patients with newly diagnosed pulmonary sarcoidosis (n=107) and those with pulmonary plus extrapulmonary sarcoidosis (n=54).
Extrapulmonary sarcoidosis was diagnosed in 33% of patients, mostly affecting lymph nodes and skin and having hypercalciuria. There was no difference in the prevalence of extrapulmonary sarcoidosis between genders. Patients with extrapulmonary sarcoidosis were older and mostly non-smokers when compared to those with limited pulmonary form. X-ray Stage I and erythema nodosum were less frequent in extrapulmonary disease. Serum levels of CRP, SACE, sIL-2R and neopterin and BAL cellular profile did not differ between both phenotypes. We observed lower platelets, FEV1, VC, and BAL CD19+ in females with extrapulmonary involvement than in those with pulmonary disease.
Affected lymph nodes, skin and hypercalciuria were the most common in sarcoidosis patients with extrapulmonary involvement. Pulmonary sarcoidosis did not differ in clinical and routine laboratory parameters from pulmonary plus extrapulmonary sarcoidosis. Observation of low platelets, VC, FEV1 and BAL CD19+ in females with extrapulmonary sarcoidosis needs further verification in larger cohort.
肺部结节病患者以及肺部合并肺外结节病患者在症状严重程度和健康状况受损方面存在差异。迄今为止,尚无关于这些表型之间临床和实验室参数差异的信息,且捷克结节病患者肺外受累情况的信息有限。
因此,我们比较了新诊断的肺部结节病患者(n = 107)和肺部合并肺外结节病患者(n = 54)的临床数据(年龄、性别、器官受累情况、肺功能测试)和实验室数据(血细胞计数、支气管肺泡灌洗(BAL)细胞谱、血清CRP、SACE、sIL - 2R、新蝶呤水平)。
33%的患者被诊断为肺外结节病,主要累及淋巴结和皮肤,并伴有高钙尿症。肺外结节病的患病率在性别之间无差异。与局限性肺部结节病患者相比,肺外结节病患者年龄更大,且大多不吸烟。肺外疾病中X线I期和结节性红斑较少见。两种表型之间血清CRP、SACE、sIL - 2R和新蝶呤水平以及BAL细胞谱无差异。我们观察到肺外受累女性的血小板、FEV1、VC和BAL CD19 +水平低于肺部疾病女性。
受累淋巴结、皮肤和高钙尿症在肺外受累的结节病患者中最为常见。肺部结节病在临床和常规实验室参数方面与肺部合并肺外结节病无差异。肺外结节病女性中血小板、VC、FEV1和BAL CD19 +水平较低的观察结果需要在更大队列中进一步验证。