Focus on Sarcoidosis
- We thank Drs. Valentin, Hyde, Gomez and Patel for commenting on our recently published article “Sarcoidosis and IPF in the same patient-a coincidence, an association or a phenotype?” . Indeed, one of our objectives in reporting our observations was to provoke further interest in the scientific community regarding such patients and conduct of clinical studies in such cohorts.
- The diagnosis of cardiac sarcoidosis (CS) is difficult to ascertain due to the insensitivity of endomyocardial biopsy. Current diagnostic criteria require a positive endomyocardial biopsy or extra-cardiac biopsy with clinical features suggestive of CS. Common tests for diagnosis of pulmonary sarcoidosis include bronchoalveolar lavage (BAL), lung and mediastinal lymph node (MLN) biopsies. Our objective was to determine the diagnostic utility of these tests in patients with suspected CS and without prior history of pulmonary involvement.
- Idiopathic Pulmonary Fibrosis (IPF) and Sarcoidosis are distinct clinical entities. Fibrotic disease in pulmonary sarcoidosis is typically upper lobe predominant. In IPF fibrosis is basilar and peripheral predominant [usual interstitial pneumonia (UIP) pattern]. Sarcoidosis and UIP have rarely been observed in the same patient. We sought to characterize patients manifesting both sarcoidosis and IPF and compare clinical features and survival to that of patients with “Lone-IPF” (IPF only) and pulmonary sarcoidosis with fibrosis in a non-UIP pattern.