PROGNOSIS OF CHRONIC SARCOIDOSIS
PROGNOSIS OF CHRONIC SARCOIDOSIS
复制标题
慢性结节病的预后
DOI：
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发表时间：
1976
影响因子：
5.2
通讯作者：
R. Rosner
中科院分区：
文献类型：
--
作者：
K. Wurm;R. Rosner
The prognosis of sarcoidosis as demonstrated in our patient population is governed by its characteristics. These investigations especially refer to chronic intrathoracic sarcoidosis, i.e., cases unnoticed by the patients in the beginning of the disease. Usually they are discovered by chance, e.g., by mass radiography, or because of additional extrathoracic lesions or any subjective complaint. Consequently, in chronic sarcoidosis the actual beginning of the disease is usually not known. Thus, in my report “onset of the disease” means the moment at which the disease was first detected. From our total number of 7,000 documented patients, 2,510 cases of chronic sarcoidosis have so far been analyzed by computer methods. The evaluated observations extend in the individual cases over very different periods of time. The preliminary limit of information in all cases is the reexamination in the years 197 1-72. Not considered in our statistical calculations is sarcoidosis with acute symptoms, the onset of which is signaled fairly exactly by impressive complaints and findings. The very favorable prognosis of such cases is generally known. In chronic sarcoidosis, our new, extensive investigations confirm the earlier fatality rate of about 5%. Illness of sarcoidosis means a considerable shortening of life expectancy: 75% died at younger than 60 yr of age. The majority actually died between 50 and 60 yr. Direct cause of death in most cases is pulmonary insufficiency followed by chronic cor pulmonale. Rarely did sarcoidosis of the heart, cerebral and renal sarcoidosis or aspergilloma lead to death. The course of the sarcoidosis is of special interest. We can interpret the columns of x-ray findings in TABLE 1 as follows: The extreme values in Groups 1 and 2 with the longest observation periods cannot be regarded as referring to duration of disease. On the one hand, these 2 groups are biased by negative selection since they are older, and incompletely cured cases who have been hospitalized exert great weight in the results. On the other hand, the small percentages in the “Normal” column tell us nothing about the actual moment healing occurred. The percentage of persistent pathological x-ray findings in Groups 3 and 4 is still very high. Indeed, the data are not identical with activity of disease. Taking into account the unknown latency period prior to discovery of the disease, it becomes evident that in chronic sarcoidosis a pathologic x-ray finding often lasts over decades and not infrequently a lifetime. Only in the minority is a remission and restitution to be expected. The clinical and functional importance of the persistent findings is indicated by patients working capacity: 11% were partially restricted for life, 8% being completely invalid. Knowledge of the general statistics is primarily of scientific interest. But the physician requires it to judge the prognosis of the individual case. Therefore the following studies concern the many factors that affect the course and outcome of
