Introduction :

In sarcoidosis,reduction in mortality and the prevention of disability due to major organ involvement are treatment goals.Thus,it is important to recognize severe disease.


To study management and prognosis of severe sarcoidosis.

Methods :

Retrospective multicenter study conducted between 2000 and 2021 including patients hospitalized with severe sarcoidosis.The factors of severity retained were:pulmonary arterial hypertension (PAH),chronic respiratory insufficiency (CRI),pulmonary fibrosis,cardiac and/or neurological and/or renal localization,resistance and/or dependence to corticosteroids and chronicity.

Methods :

We enrolled 214 patients with sarcoidosis among whom 92 patients had severe sarcoidosis: 26 patients with pulmonary fibrosis,11 patients with cardiac sarcoidosis,9 patients with neurosarcoidosis ,38 patients with PAH and 8 patients with chronic sarcoidosis.The mean age was 52 years old[24-77years] with a sex ratio equal to 0.39.Systemic corticosteroid therapy was prescribed in 87% of cases over an average period of 19 months,immunosuppressive therapy in 15.2% of cases over an average period of 15 months and synthetic antimalarials drugs in 3.3% of cases.A complete clinical remission was noted in 13% of cases.A relapse was observed in 87% of our patients.It was a pulmonary relapse in 93% of cases and cardiac relapse in 7% of cases.For those patients,immunosuppressive therapy was combined with corticosteroid therapy in 53% of cases.The evolution was marked by recovery in 33% of cases,progression to CRI was in 8.7% of cases,chronicity in 51% of cases and death in 5,3% of cases.

Conclusion :

Severe sarcoidosis requires more monitoring to prevent the disease progression towards severe outcomes.