Abstract
Sarcoidosis is a systemic granulomatous disease that frequently involves the lung. Although classically thought of as a restrictive lung disease, airway obstruction has become a recognized feature of the disease in the past years. Sarcoidosis can affect the airway at any level and when the involvement includes small airways, it can resemble more common obstructive airway diseases, such as asthma and chronic bronchitis. Pulmonary function testing and high-resolution computerized tomography of the chest are two important tools to evaluate the presence and extent of airway obstruction in sarcoidosis. Pharmacologic options for the treatment of obstructive sarcoidosis are, in large part, not supported by large randomized clinical trials. In severe cases of bronchostenosis owing to sarcoidosis granuloma or extrinsic compression from intrathoracic lymphadenopathy, interventional bronchoscopy has successfully been performed, although repeated procedures are usually required. Lung transplantation is an ultimate option in selected patients with late-stage fibrotic disease.
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James, D.G. (1997), Clin. Chest Med. 18(4), 663–679.
Sharma, O.P. and Johnson, R. (1998). Chest 94(2), 343–346.
Hosoda, Y., Yamaguchi, M., and Hiraga, Y. (1997), Clin. Chest Med. 18(4), 681–694.
Henke, C.E., Henke, G., Elveback, L.R., et al. (1986), Am. J. Epidemiol. 123(5), 840–845.
James, G. (1994), M. Dekker, New York, p. 859.
Mana, J., Badrinas, F., Morera, J., et al. (1992), Sarcoidosis 9(2), 118–122.
Siltzbach, L.E., James, D.G., Neville, E., et al. (1974), Am. J. Med. 57(6), 847–852.
McNicol, M.W. and Luce, P.J. (1985), J. R. Coll. Physicians Lond. 19(3), 179–183.
Edmondstone, W.M. and Wilson, A.G. (1985), Br. J. Dis. Chest 79(1), 27–36.
Pietinalho, A., Ohmichi, M., Hiraga, Y., Lofroos, A.B., and Selroos, O. (1996), Sarcoidosis Vasc. Diffuse Lung Dis. 13(2), 159–166.
Baughman, R.P., Teirstein, A.S., Judson, M. A., et al. (2001), Am. J. Respir. Crit. Care Med. 164 (10 Pt 1), 1885–1889.
Harrison, B.D., Shaylor, J.M., Stokes, T. C., and Wilkes, A.R. (1991), Respir. Med. 85(1), 59–64.
Hunninghake, G.W., Costabel, U., Ando, M., et al. (1999), Sarcoidosis Vasc. Diffuse Lung Dis. 16(2), 149–173.
Brennan, N.J., Crean, P., Long, J.P., and Fitzgerald, M.X. (1984), Thorax 39(1), 14–18.
Rybicki, B.A., Kirkey, K.L., Major, M., et al. (2001), Am. J. Epidemiol. 153(2), 188–193.
Rybicki, B.A., Iannuzzi, M.C., Frederick, M.M., et al. (2001), Am. J. Repir. Crit. Care Med. 164(11), 2085–2091.
Newman, L.S., Rose, C.S., and Maier, L.A. (1997), N. Engl. J. Med. 336(17), 1224–1234.
Martinetti, M., Tinelli, C., Kolek, V., et al. (1995), Am. J. Respir. Crit. Care Med. 152(2), 557–564.
Bresnitz, E.A., Stolley, P.D., Israel, H.L., and Soper, K. (1986), Ann. N. Y. Acad. Sci. 465, 632–642.
Edmondstone, W.M. (1988), Thorax 43(4), 342–343.
Parkes, S.A., Baker, S.B., and Bourdillon, R.E., et al. (1985), Thorax 40(4), 284–287.
Siltzbach, L.E. (1964), Acta Med. Scand. Suppl. 425, 74–78.
Burke, W.M., Keogh, A., Maloney, P.J., Delprado, W., Bryant, D.H., and Spratt, P. (1990), Lancet 336(8730), 1579.
Heyll, A., Meckenstock, G., Aul, C., et al. (1994), Bone Marrow Transplant 14(1), 161–164.
Mitchell, I.C., Turk, J.L., and Mitchell, D.N. (1992), Lancet 339(8800), 1015–1017.
Saboor, S.A., Johnson, N.M., and McFadden, J. (1992), Lancet 339(8800), 1012–1015.
Bocart, D., Lecossier, D., De Lassence, A., Valeyre, D., Battesti, J.P., and Hance, A.J. (1992), Am. Rev. Respir. Dis. 145(5), 1142–1148.
Richter, E., Greinert, U., Kirsten, D., et al., (1996), Am. J. Respir. Crit. Care Med. 153(1), 375–380.
Vokurka, M., Lecossier, D., du Bois, R.M., et al. (1997), Am. J. Respir. Crit. Care Med. 156(3 Pt 1), 1000–1003.
Wilsher, M.L., Menzies, R.E., and Croxson, M.C. (1998), Thorax 53(10), 871–874.
Martens, H., Zollner, B., Zissel, G., Burdon, D., Schlaak, M., and Muller-Quernheim, J. (1997), Eur. Respir. J. 10(6), 1356–1358.
Nilsson, K., Pahlson, C., Lukinius, A., Eriksson, L., Nilsson, L., and Lindquist, O. (2002), J. Infect. Dis. 185(8), 1128–1138.
Mills, G.D., Allen, R.K., and Timms, P., (1998), Pathology 30(3), 295–298.
Blasi, F., Rizzato, G., Gambacorta, M., et al. (1997), Eur. Respir. J. 10(11), 2609–2611.
Lebbe, C., Agbalika, F., Flageul, B., et al. (1999), Br. J. Dermatol. 141(3), 492–496.
Ishige, I., Usui, Y., Takemura, T., and Eishi, Y. (1999), Lancet 354(9173), 120–123.
Agostini, C., Adami, F., and Semenzato, G. (2000), Cur. Opin. Rheumatol. 12(1), 71–76.
Hunninghake, G.W., Garrett, K.C., Richerson, H.B., et al. (1984), Am. Rev. Respir. Dis. 130(3), 476–496.
NIH conference. (1981), Ann. Intern. Med. 94(1), 73–94.
Semenzato, G., Chilosi, M., Ossi, E., et al. (1985), Am. Rev. Respir. Dis. 132(2), 400–404.
Campbell, D.A., Poulter, L.W., and du Bois, R.M. (1985), Am. Rev. Respir. Dis. 132(6), 1300–1306.
Forrester, J.M., Wang, Y., Ricalton, N., et al. (1994), J. Immunol. 153(9), 4291–4302.
Forman, J.D., Klein, J.T., Silver, R.F., Liu, M.C., Greenlee, B.M., and Moller, D.R. (1994), J. Clin. Invest. 94(4), 1533–1542.
Klein, J.T., Horn, T.D., Forman, J.D., Silver, R.F., Teirstein, A.S., and Moller, D.R. (1995), J. Immunol. 154(3), 1450–1460.
Moller, D.R., Konishi, K., Kirby, M., Balbi, B., and Crystal, R.G. (1988), J. Clin. Invest. 82(4), 1183–1191.
Grunewald, J., Olerup, O., Persson, U., Ohrn, M.B., Wigzell, H., and Eklund, A. (1994), Proc. Natl. Acad. Sci. USA 91(11), 4965–4969.
Grunewald, J., Janson, C.H., Eklund, A., et al. (1992), Eur. J. Immunol. 22(1), 129–135.
Agostini, C., Trentin, L., Facco, M., et al. (1996), J. Immunol. 157(2), 910–918.
Agostini, C., Zambello, R., Sancetta, R., et al. (1996), Am. J. Respir. Crit. Care Med. 153(4 pt 1), 1359–1367.
Semenzato, G., Agostini, C., Trentin, L., et al. (1984), Clin. Exp. Immunol. 57(2), 331–337.
Saltini, C., Spurzem, J.R., Lee, J.J., Pinkston, P., and Crystal, R.G., (1986), J. Clin. Invest., 77(6), 1962–1970.
Robinson, B.W., McLemore, T.L., and Crystal, R.G. (1985), J. Clin. Invest. 75(5), 1488–1495.
Shigehara, K., Shijubo, N., Ohmichi, M., et al. (2001), J. Immunol. 166(1), 642–649.
Girgis, R.E., Basha, M.A., Maliarik, M., Popovich, J., Jr., and Iannuzzi, M.C. (1995), Am. J. Respir. Crit. Care Med. 152(1), 71–75.
Muller-Quernheim, J. (1998), Eur. Respir. J. 12(3), 716–738.
Bergeron, A., Bonay, M., Kambouchner, M., et al. (1997), J. Immunol. 159(6), 3034–3043.
Kitaichi, M. (1986), Clin. Dermatol. 4(4), 108–115.
Takemura, T., Matsui, Y., Saiki, S., and Mikami, R. (1982), Hum. Pathol. 23(11), 1216–1223.
Lynch, J.P., 3rd, Kazerooni, E.A., and Gay, S.E. (1997), Clin. Chest Med. 18(4), 755–785.
Sharma, O.P. and Badr, A. (1994), Clinical Pulmonary Medicine 1, 18–26.
Rizzato, G. (2001), Curr. Opin. Pulm. Med. 7(5), 295–297.
Israel, H.L., Karlin, P., Menduke, H., and DeLisser, O.G. (1986), Ann. N. Y. Acad. Sci. 465, 609–618.
Neville, E., Walker, A.N., and James, D.G. (1983), Q. J. Med. 52(208), 525–533.
Mana, J., Salazar, A., and Manresa, F. (1994), Respiration 61(4), 219–225.
Takada, K., Ina, Y., Noda, M., Sato, T., Yamamoto, M., and Morishita, M. (1993), J. Clin. Epidemiol. 46(4), 359–366.
Murdoch, J. and Muller, N.L. (1992), AJR Am. J. Roentgenol. 159(3), 473–477.
Remy-Jardin, M., Giraud, F., Remy, J., Wattinne, L., Wallaert, B., and Duhamel, A. (1967), Radiology 191(3), 675–680.
Siltzbach, L.E. (1967), Med. Clin. North Am. 51(2), 483–502.
Consensus conference: activity of sarcoidosis. Third WASOG meeting, Los Angeles, USA, September 8–11, 1993. Eur. Respir. J. 7(3), 624–627.
Allen, R.K. (1991), Sarcoidosis 8(2), 95–100.
Beneteau-Burnat, B. and Baudin, B. (1991), Crit. Rev. Clin. Lab. Sci. 28(5–6), 337–356.
Fuss, M., Pepersack, T., Gillet, C., Kartnali, R., and Corvilain, J. (1992), Clin. Rheumatol. 11(1), 28–36.
Verstraeten, A., Demedts, M., Verwilghen, J., et al. (1990), Chest 98(3), 560–567.
Winterbauer, R.H., Lammert, J., Selland, M., Wu, R., Corley, D., and Springmeyer, S.C. (1993), Chest 104(2), 352–361.
Poe, R.H., Israel, R.H., Utell, M.J., and Hall, W.J. (1979), Arch. Intern. Med. 139(7), 761–763.
Koerner, S.K., Sakowitz, A.J., Appelman, R.I., Becker, N.H., and Schoenbaum, S.W. (1975), N. Engl. J. Med. 293(6), 268–270.
Gilman, M.J. and Wang, K.P. (1980), Am. Rev. Respir. Dis. 122(5), 721–724.
Shorr, A.F., Torrington, K.G., and Hnatiuk, O.W. (2001), Chest 120(1), 109–114.
Levinson, R.S., Metzger, L.F., Stanley, N.N., et al. (1977), Am. J. Med. 62(1), 51–59.
Stjernberg, N. and Thunell, M. (1984), Acta Med. Scand. 215(2), 121–126.
Loddenkemper, R., Kloppenborg, A., Schoenfeld, N., Grosser, H., and Costabel, U. (1998), Sarcoidosis Vasc. Diffuse Lung Dis. 15(2), 178–182.
Cieslicki, J., Zych, D., and Zielinski, J. (1991), Sarcoidosis 8(1), 42–44.
Coates, R. and Neville, E. (1993), Sarcoidosis 10(2), 115–117.
Kaneko, K. and Sharma, O.P. (1977), Bull. Eur. Physiopathol. Respir. 13(2), 231–240.
DeRemee, R.A. and Andersen, H.A. (1974), Mayo Clin. Proc. 49(10), 742–745.
Viskum, K. and Vestbo, J. (1993), Eur. Respir. J. 6(3), 349–353.
Carrington, C.B. (1976), Ann. N. Y. Acad. Sci. 278, 265–283.
Young, R.C., Jr., Carr, C., Shelton, T.G., Mann, M., Ferrin, A., Laurey, J.R., and Harden, K.A. (1967), Am. Rev. Respir. Dis. 95(2), 224–238.
American Thoracic Society. (1991), Am. Rev. Respir. Dis. 144(5), 1202–1218.
Wilcox, A.G. (2000), Curr. Opin. Pulm. Med. 6(5), 399–403.
Gevenois, P.A., De Vuyst, P., Sy, M., et al. (1996), Radiology 199(3), 825–829.
Gleeson, F.V., Traill, Z.C., and Hansell, D.M. (1996), AJR Am. J. Roentgenol. 166(5), 1052–1054.
Hansell, D.M., Milne, D.G., Wilsher, M.L., and Wells, A.U. (1998), Radiology 209(3), 697–704.
Fazzi, P., Sbragia, P., Solfanelli, S., Troilo, S., and Giuntini, C. (2001), Chest 119(4), 1270–1274.
Davies, C.W., Tasker, A.D., Padley, S.P., Davies, R.J., and Gleeson, F.V. (2000), Clin. Radiol. 55(3), 217–221.
Armstrong, J.R., Radke, J.R., Kvale, P.A., Eichenhorn, M.S., and Popovich, J., Jr. (1981), Ann. Otol. Rhinol. Laryngol. 90(4 Pt 1), 339–343.
Udwadia, Z.F., Pilling, J.R., Jenkins, P.F., and Harrison, B.D. (1990), Thorax 45(4), 272–275.
Lenique, F., Brauner, M.W., Grenier, P., Battesti, J.P., Loiseau, A., and Valeyre, D. (1995), Radiology 194(2), 419–423.
Curtin, J.J., Innes, N.J., and Harrison, B.D. (1998), Clin. Radiol. 53(2), 110–115.
Fouty, B.W., Pomeranz, M., Thigpen, T.P., and Martin, R.J. (1994), Chest 106(3), 677–680.
Olsson, T., Bjornstad-Pettersen, H., and Stjernberg, N.L. (1979), Chest 75(6), 663–666.
Cohen, M. and Sahn, S.A. (1999), Chest 116(4), 1063–1074.
Lewis, M.M., Mortelliti, M.P., Yeager, H., Jr., and Tsou, E. (2002), Sarcoidosis Vasc. Diffuse Lung Dis. 19(2), 154–159.
Bechtel, J.J., Starr, T., 3rd, Dantzker, D.R., and Bower, J.S. (1981), Am. Rev. Respir. Dis. 124(6), 759–761.
Marcias, S., Ledda, M.A., Perra, R., Severino, C., and Rosetti, L. (1994), Sarcoidosis 11(2), 118–122.
Olafsson, M., Simonsson, B.G., and Hansson, S.B. (1985), Thorax 40(1), 51–53.
Plusa, T., Chcialowski, A., Piechota, W., and Pirozynski, M. (1990), Allergol Immunopathol. (Madr.) 18(4), 217–221.
Niimi, T., Tomita, H., Sato, S., Mori, T., Kawaguchi, H., Sugiura, Y., and Matsuda, R. (1998), Chest 114(2), 495–459.
Shorr, A.F., Torrington, K.G., and Hnatiuk, O.W. (2001), Chest 120(3), 881–886.
Judson, M.A. (1999), Chest 115(4), 1158–1165.
Paramothayan, S. and Jones, P.W. (2002), JAMA 287(10), 1301–1307.
Hunninghake, G.W., Gilbert, S., Pueringer, R., et al. (1994), Am. J. Respir. Crit. Care Med. 149(4 Pt 1), 893–898.
Lavergne, F., Clerici, C., Sadoun, D., Brauner, M., Battesti, J.P., and Valeyre, D. (1999), Chest 116(5), 1194–1199.
Johns, C.J., Macgregor, M.I., Zachary, J.B., and Ball, W.C. (1976), Ann. N. Y. Acad. Sci. 278, 722–731.
Colp, C., Park, S.S., and Williams, M.H., Jr. (1976), Ann. N. Y. Acad. Sci. 278, 301–307.
Gilbson, G.J., Prescott, R.J., Muers, M.F., et al. (1996), Thorax 51(3), 238–247.
Pietinalho, A., Tukiainen, P., Haahtela, T., Persson, T., and Selroos, O. (1999), Chest 116(2), 424–431.
Pietinalho, A., Tukiainen, P., Haahtela, T., Persson, T., and Selroos, O. (2002), Chest 121(1), 24–31.
Spiteri, M.A., Newman, S.P., Clarke, S.W., and Poulter, L.W. (1989), Eur. Respir. J. 2(3), 218–224.
Erkkila, S., Froseth, B., Hellstrom, P.E., et al. (1988), Sarcoidosis 5(2), 106–110.
Alberts, C., van der Mark, T.W., and Jansen, H.M. (1995), Eur. Respir. J. 8(5), 682–688.
Milman, N., Graudal, N., Grode, G., and Munch, E. (1994), J. Intern. Med. 236(3), 285–290.
Zych, D., Pawlicka, L., and Zielinski, J. (1993), Sarcoidosis 10(1), 56–61.
Wyser, C.P., van Schalkwyk, E.M., Alheit, B., Bardin, P.G., and Joubert, J.R. (1997), Am. J. Respir. Crit. Care Med. 156(5), 1371–1376.
Israel, H.L. and McComb, B.L. (1991), Sarcoidosis 8(1), 35–41.
Carlesimo, M., Giustini, S., Rossi, A., Bonaccorsi, P., and Calvieri, S. (1995), J. Am. Acad. Dermatol. 32(5 Pt 2), 866–869.
Baughman, R.P. and Lower, E.E. (1997), Clin. Chest Med. 18(4), 853–864.
Pacheco, Y., Marechal, C., Marechal, F., Biot, N., and Perrin Fayolle, M. (1985), Sarcoidosis 2(2), 107–113.
Muller-Quernheim, J., Kienast, K., Held, M., Pfeifer, S., and Costabel, U. (1999), Eur. Respir. J. 14(5), 1117–1122.
Lower, E.E. and Baughman, R.P. (1995), Arch. Intern. Med. 155(8), 846–851.
Baughman, R.P. and Lower, E.E. (1999), Thorax 54(8), 742–746.
Baltzan, M., Mehta, S., Kirkham, T.H., and Cosio, M.G. (1999), Am. J. Respir. Crit. Care Med. 160(1), 192–197.
Baughman, R.P. (1998), Sarcoidosis Vasc. Diffuse Lung Dis. 15(2), 147–149.
Sharma, O.P. (1996), Chest 109(2), 535–539.
Brown, K.T., Yeoh, C.B., and Saddekni, S. (1988), AJR Am. J. Roentgenol. 150(3), 553–554.
Carlin, B.W., Harrell, J.H., 2nd, and Moser, K.M. (1988), Chest 93(6), 1148–1151.
Putnam, J.B., Jr. (1993), Chest 104(6), 1651–1652.
Chan, A.L., Yoneda, K.Y., Allen, R.P., and Albertson, T.E. (2003), Current Opinions Pulm. Med. (in press).
Chan, A.L., Tharratt, R.S., Siefkin, A.D., Albertson, T.E., Volz, W.G., and Allen, R.P. (1990), Chest 98(2), 271–275.
Colt, H.G. and Dumon, J. (1991), J. Respir. Dis. 12(8), 741–749.
Padilla, M.L., Schilero, G.J., and Teirstein, A.S. (1997), Sarcoidosis Vasc. Diffuse Lung Dis. 14(1), 16–22.
Kazerooni, E.A., Jackson, C., and Cascade, P.N. (1994), Radiology 192(2), 461–464.
Carre, P., Rouquette, I., Durand, D., et al. (1995), Transplant Proc. 27(2), 1686.
Johnson, B.A., Duncan, S.R., Ohori, N.P., et al. (1993), Am. Rev. Respir. Dis. 148(5), 1373–1377.
Casavilla, F.A., Gordon, R., Wright, H.I., Gavaler, J.S., Starzl, T.E., and Van Thiel, D.H. (1993), Ann. Intern. Med. 118(11), 865–866.
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Laohaburanakit, P., Chan, A. Obstructive sarcoidosis. Clinic Rev Allerg Immunol 25, 115–129 (2003). https://doi.org/10.1385/CRIAI:25:2:115
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DOI: https://doi.org/10.1385/CRIAI:25:2:115