Background

Sarcoidosis can affect the airway at any level and its involvement is associated with increased morbidity, respiratory symptoms and mortality. Although restrictive ventilatory pattern, caused by parenchymal disease, is the leading pulmonary function abnormality, airway obstruction is a relatively common finding

Objectives

To evaluate the prevalence of obstructive airway disease in patients with sarcoidosis and to assess its evolution and the role of therapeutic interventions.

Methods

Patients with pulmonary sarcoidosis, diagnosed in our ILD unit since 2015, were retrospectively included. Clinical data, lung function tests and ongoing therapy were collected at baseline and at 12 months. ANOVA tests were performed to evaluate the correlation between selected variables (obstructive disease and specific treatment) and LFTs relative decline at follow-up.

Results

Eighty-one patients (39 males; mean age 57.6 yrs) were included; mean FEV1 was 88%, mean FVC 96% and mean DLCO 75%. Twenty-two percent of patients had an airflow limitation (FEV1/FVC <70%): 33 of these were on steroid treatment, 6 on bronchodilators, 6 received both. Both FEV1/FVC% and FEF-25-75% relative decline at 1-year significantly correlated with airway obstruction at baseline (p-value: 0,001 and p-value: 0,014 respectively) and was influenced by treatment received, being reduced in patients on steroids and/or bronchodilators (p-value 0,005 and p-value 0,007).

Conclusions

Obstructive airway disease is a relatively common finding in patients with sarcoidosis. Our data documented that both large and small airway dysfunction is relevant in sarcoidosis and can worsen over time, although steroids and/or bronchodilators may be helpful in preventing further decline