Sarcoidosis of the lung. Natural history and effects of treatment.

An analysis on the natural course of pulmonary sarcoidosis and effects of corticotherapy was carried out in 960 patients observed during 25 years (1959-1985). There were 434 males and 526 females in the studied group aged from 14 to 69 years, when entering the study. The time of follow-up ranged from 2 to 20 years. In 20% of subjects disease had an acute course, in the remaining 80% the process was symptomless, often of chronic nature. Majority of patients presented with stage I or stage II of the disease (respectively 48.2% and 48.6%). Histological confirmation was obtained in 70% of subjects. Spontaneous remission or improvement was observed in 62.2%. Remission or improvement following treatment was seen in another 18.7% (a beneficial effect being observed in 84.1% of treated patients). Altogether remission or improvement, spontaneous or after treatment, was seen in 80.9% of studied group. In the remaining 19.1%, 2.8% of whom were treated and 16.3% not treated, a progression of the pulmonary changes was observed-the disease evolved into chronic stage. In acute pulmonary sarcoidosis the evolution of the disease was more favorable. Remission or improvement, spontaneous or after treatment, was observed in 89.3% of patients, versus 76.3% of patients with symptomless course of the disease. Recurrence of the disease was observed in 21 cases. It was seen only in treated patients shortly after completion of treatment.