Clinical features and diagnostic approach to sarcoidosis according to stages

Seventy-seven patients with sarcoidosis followed in our department evaluated retrospectively and the study continued prospectively. Depending on the radiologic findings, 26 (33.8%) of these cases were considered to be in stage 1, 47 (61.0%) were in stage 2 and 4 (5.2%) were in stage 3. Erythema nodosum was found in 29 (37.7%) cases; 15 (51.7%) of whom were stage 1, 13 (44.8%) were stage 2 and 1 (3.4%) was stage 3. There was peripheral lymphadenopathy in 8 (10.4%) cases. Bronchoscopy was performed in 68 cases and 55 found to be normal. BAL was determined in 50 of those to whom bronchoscopy had been performed. Mean BAL lymphocyte rate was found to be 32.2% and it was 36.1% in stage 1, 31.1% in stage 2 and 22.2% in stage 3. Diagnosis of sarcoidosis was confirmed with histopathologic examination in 48 cases and with BAL and other clinical signs in the others. It was confirmed with parenchymal biopsy in 15 cases, with scalene lymph node biopsy in 8 cases, with bronchial mucosa biopsy in 5, with transcranial needle aspiration biopsy in 5, with video-assisted thoracoscopic surgery in 4, with right supraclavicular lymph node biopsy in 3 and with skin biopsy in 2 cases. Tuberculin skin test was performed in 67 cases and was found to be negative in 51 (76.1%). Serum ACE levels were checked in 11 cases and found to be high in 7 of them (63.6%) (mean: 21.9). Two of 55 cases who had neurologic examination, 3 of 60 cases who had fundoscopy were found to have pathologic findings.