Abstract
Purpose :
To investigate the clinical features of transbronchial biopsy-proven pulmonary sarcoidosis compared with other biopsy proven sarcoidosis
Methods :
Patients who were diagnosed as sarcoidosis by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) were included. (n=38) All patients were referred to ophthalmology department and had comprehensive ophthalmologic examinations. The patients, who had an evidence of other granulomatous disease, or other cause of uveitis, were excluded. By retrospective clinical chart review, we investigated demographic data, an episode of uveitis attack, type of uveitis, serum angiotensin converting enzyme (ACE) assay, chest radiography, pulmonary function test any event of ocular complication, or treatment. For a comparison, other biopsy confirmed sarcoidosis patients who was diagnosed by excisional biopsy of hilar lesion (n=8), or extrapulmonary lesion (n=9) were investigated as control.
Results :
EBUS-TBNA biopsy group showed mean age of 53.8 years and female dominance (31 out of 38). 21 patients (65.8%) were found ocular manifestations with 81.0% of bilaterality. Mean age, Female dominance, serum ACE level, systemic treatment rate were higher in ocular involvement group (54.4, 0.88, 79.4, 0.68, respectively) than that of uveitis free group (49.3, 0.69, 64.1, 0.31) and only systemic treatment rate, especially immunomodulation (0.36 compared with 0) was showed statistical significance. (p=0.03) Age, sex ratio, ocular involvement, bilaterality, bihilar lymphadenopathy, serum ACE level, systemic treatment rate were not showed significant difference by type of biopsy confirmation, but ocular involvement and systemic treatment rate were slightly higher in extrapulmonary biopsy group.
Conclusions :
In patients with transbronchial biopsy-proven sarcoidosis, 65.8% of ocular manifestations were found with insignificantly higher age, female ratio, serum ACE level. Ocular involvement was a significant factor associated with systemic treatment, especially immunosuppressive agents. Type of biopsy was not a significant factors associated with clinical features, but patients with extrapulmonary lesion showed more ocular involvement and aggressive treatment.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.