Sarcoidosis natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Roshan Dinparasti Saleh M.D.

Overview

The overall mortality in sarcoidosis is low (about 5%), and many patients with spontaneous regression will never require treatment. Complications include pulmonary hypertension, fatigue, osteoporosis, aspergilloma, arrhythmias, and renal failure.

Natural History

The overall mortality in sarcoidosis is low (about 5%), and many patients with spontaneous regression will never require treatment^[1]. In people who need treatment, important differences exist between African-American and white patients. African-American patients with sarcoidosis experience a more severe and systemic disease and 12 times higher mortality ^[2]

Complications

SAPH: sarcoidosis-associated pulmonary hypertension^[3]^[4]
Fatigue^[5]
Osteoporosis^[6]^[7]
Aspergilloma^[8]^[9]^[10]
Ventricular arrhythmias^[11]
Saddle nose defirmity
Renal failure due to hypercalcemia and/or intersitial nephritis^[12]
Lung fibrosis

Prognosis

African-American patients with sarcoidosis experience a more severe and systemic disease and 12 times higher mortality ^[2]

References

↑ Gerke AK: Morbidity and mortality in sarcoidosis. Curr Opin Pulm Med 20:472–478, 2014.
↑ ^2.0 ^2.1 Mirsaeidi M, et al: Racial difference in sarcoidosis mortality in the United States. Chest 147:438–449, 2015.
↑ Fisher KA, Serlin DM, Wilson KC, et al: Sarcoidosis-associated pulmonary hypertension: outcome with long term epoprostenol treatment. Chest 130(5):1481–1488, 2006.
↑ Preston IR, Klinger JR, Landzberg MJ, et al: Vasoresponsiveness of sarcoidosis-associated pulmonary hypertension. Chest 120(3):866–872, 2001.
↑ de Kleijn WP, de Vries J, Lower EE, et al: Fatigue in sarcoidosis: a systematic review. Curr Opin Pulm Med 15(5):499–506, 2009.
↑ Kavathia D, Buckley JD, Rao D, et al: Elevated 1, 25-dihydroxyvitamin D levels are associated with protracted treatment in sarcoidosis. Respir Med 104(4):564–570, 2010.
↑ Gonnelli S, Rottoli P, Cepollaro C, et al: Prevention of corticosteroidinduced osteoporosis with alendronate in sarcoid patients. Calcif Tissue Int 61(5):382–385, 1997.
↑ Denning DW, Pleuvry A, Cole DC: Global burden of chronic pulmonary aspergillosis complicating sarcoidosis. Eur Respir J 41(3):621–626, 2013.
↑ Pena TA, Soubani AO, Samavati L: Aspergillus lung disease in patients with sarcoidosis: a case series and review of the literature. Lung 189(2):167–172, 2011.
↑ Baughman RP, Lower EE: Fungal infections as a complication of therapy for sarcoidosis. QJM 98:451–456, 2005.
↑ Birnie DH, Sauer WH, Bogun F, et al: HRS expert concensus statement on the diagnosis and management of arrhythmias associated with cardiac sarcoidosis. Heart Rhythm 11(7):1305–1323, 2014.
↑ Mahevas M, Lescure FX, Boffa JJ, et al: Renal sarcoidosis: clinical, laboratory, and histologic presentation and outcome in 47 patients. Medicine (Baltimore) 88(2):98–106, 2009.

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[1] Gerke AK: Morbidity and mortality in sarcoidosis. Curr Opin Pulm Med 20:472–478, 2014.

[africa-2] 2.0 ^2.1 Mirsaeidi M, et al: Racial difference in sarcoidosis mortality in the United States. Chest 147:438–449, 2015.

[3] Fisher KA, Serlin DM, Wilson KC, et al: Sarcoidosis-associated pulmonary hypertension: outcome with long term epoprostenol treatment. Chest 130(5):1481–1488, 2006.

[4] Preston IR, Klinger JR, Landzberg MJ, et al: Vasoresponsiveness of sarcoidosis-associated pulmonary hypertension. Chest 120(3):866–872, 2001.

[5] Kleijn WP, de Vries J, Lower EE, et al: Fatigue in sarcoidosis: a systematic review. Curr Opin Pulm Med 15(5):499–506, 2009.

[6] Kavathia D, Buckley JD, Rao D, et al: Elevated 1, 25-dihydroxyvitamin D levels are associated with protracted treatment in sarcoidosis. Respir Med 104(4):564–570, 2010.

[7] Gonnelli S, Rottoli P, Cepollaro C, et al: Prevention of corticosteroidinduced osteoporosis with alendronate in sarcoid patients. Calcif Tissue Int 61(5):382–385, 1997.

[8] Denning DW, Pleuvry A, Cole DC: Global burden of chronic pulmonary aspergillosis complicating sarcoidosis. Eur Respir J 41(3):621–626, 2013.

[9] Pena TA, Soubani AO, Samavati L: Aspergillus lung disease in patients with sarcoidosis: a case series and review of the literature. Lung 189(2):167–172, 2011.

[10] Baughman RP, Lower EE: Fungal infections as a complication of therapy for sarcoidosis. QJM 98:451–456, 2005.

[11] Birnie DH, Sauer WH, Bogun F, et al: HRS expert concensus statement on the diagnosis and management of arrhythmias associated with cardiac sarcoidosis. Heart Rhythm 11(7):1305–1323, 2014.

[12] Mahevas M, Lescure FX, Boffa JJ, et al: Renal sarcoidosis: clinical, laboratory, and histologic presentation and outcome in 47 patients. Medicine (Baltimore) 88(2):98–106, 2009.

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