Does activity of pulmonary sarcoidosis depend on disease duration? A correlation between bronchoalveolar lavage, scintigraphic, radiologic, and physiologic parameters and time of onset of the disease.

In pulmonary sarcoidosis the alveolitis is thought to precede and modulate granuloma formation and fibrosis. Thus, patients with early disease may have a more active pulmonary process, while patients with long standing sarcoidosis are thought to have fibrotic, stabilized lesions. The aim of the present study is to correlate radiographic stage, alveolitis activity, and respiratory function changes with the length of the disease. For this purpose 116 patients with biopsy-proven untreated pulmonary sarcoidosis have been divided in three groups according to time of onset of the illness: group A (48 patients with sarcoidosis duration less than or equal to 3 months), group B (25 patients with sarcoidosis duration greater than 3 less than or equal to 6 months), and group C (43 patients with sarcoidosis duration greater than 6 months less than or equal to 3 years). We found a progression with time from roentgenographic stage I to III, but no correlation was present between the disease duration and T lymphocytes of BAL, results of gallium lung scans, and respiratory function values. Our results suggest that the activity of alveolitis and the derangement of respiratory function in pulmonary sarcoidosis are unrelated to the time of onset of the disease.