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Acute Pulmonary Exacerbation of Sarcoidosis

  • Efstratios PanselinasEmail author
  • Marc A. Judson
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Part of the Respiratory Medicine book series (RM, volume 17)

Abstract

Sarcoidosis patients frequently experience an acute exacerbation of pulmonary sarcoidosis (APES). Despite the frequent occurrence of APES, there is a paucity of information regarding its definition, diagnostic criteria, diagnosis, and treatment. APES is a significant clinical problem that adversely affects the quality of life of sarcoidosis patients. We propose the following clinical criteria for the diagnosis of APES: the development or worsening of pulmonary symptoms over at least a 1-month period in patients with known sarcoidosis that cannot be not explained by an alternative cause, combined with a decline in spirometry (≥10 % from previous baseline FVC and/or FEV1). Risk factors for APES include previous treatment with corticosteroids, Black race, and fibrocystic sarcoidosis. The pathogenesis of APES may involve direct or indirect effects of pulmonary granulomatous inflammation. Although relatively low-dose corticosteroid (20 mg of daily prednisone equivalent) for a relatively short time (3 weeks duration) is usually adequate to resolve APES, the corticosteroid tapering schedule and the prognosis of APES are unknown. We believe that further attention to APES will improve the quality of life of sarcoidosis patients.

Keywords

Sarcoidosis Pulmonary exacerbation Definition Risk factors Diagnosis Differential diagnosis Treatment Corticosteroids 

Abbreviations

APES

Acute pulmonary exacerbation of sarcoidosis

ART

Antiretroviral therapy

CT

Computed tomography

HIV

Human immunodeficiency virus

HLA

Human leukocyte antigen

INF

Interferon

SAPH

Sarcoidosis-associated pulmonary hypertension

TNF

Tumor necrosis factor

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© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Pulmonary Medicine411 General Army HospitalTripoliGreece
  2. 2.Division of Pulmonary and Critical Care Medicine, Department of MedicineAlbany Medical College, Albany Medical CenterAlbanyUSA

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