Abstract
Background: The ATS/ERS guideline definition of obstructive pattern in lung function tests does not consider measurement of static lung volumes as mandatory.
Methods: Patients with pulmonary sarcoidosis (n=1110; 529 males) were enrolled. Static volumes expected in association with an obstructive process was quantified in a control cohort of COPD patients (n=899; 536 males). Ventilatory defects in sarcoidosis patients, were defined according to ATS/ERS and with the reclassification of a sub-group of patients from obstructive to mixed disease, based on TLC values below those expected in the control COPD cohort.
Results: A prevalence of 10.4% of mixed disease was identified, which was associated with a higher prevalence of chest radiographic stage IV disease (p<0.0001). Patients with mixed disease demonstrated significantly lower DLco levels (50.7±16.3 vs 70.8±18.1) and higher mortality (HR 2.36, 95%CI:1.344.15, p=0.003) during follow up when compared to those with obstructive disease.
The comparison of static lung volumes between sarcoidosis with obstructive pattern (n=329) and COPD patients revealed lower static lung volumes in sarcoidosis patients, (TLC%predicted: 96.6±11.8 vs 121±17.8, p<0.0001, RV%predicted: 109.4±31.5 vs 185.3±58.1, p<0.0001). When sarcoidosis patients with obstructive pattern were re-classified, the re-classified group had lower DLco levels (59.8±14.4 vs 72.5±18, p<0.0001) and higher prevalence of stage IV disease (34/43, 79.1% vs 92/286, 32.2%, p<0.0001) compared to the remaining patients with obstructive disease.
Conclusion: Mixed disease may be underestimated in sarcoidosis using current ATS/ERS guidelines despite its high prognostic value in sarcoidosis.
Footnotes
Cite this article as: European Respiratory Journal 2018 52: Suppl. 62, PA5210.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2018