Tuberc Respir Dis > Volume 39(6); 1992 > Article
Tuberculosis and Respiratory Diseases 1992;39(6):453-473.
DOI: https://doi.org/10.4046/trd.1992.39.6.453    Published online December 1, 1992.
National survey of sarcoidosis in Korea. scientific committee in Korean academy of tuberculosis and respiratory diseases.
Abstract
Background
N ational suπey was performed to estimate the incidence of sarcoidosis in Korea. The c1 inical data of confirmed cases were analysed for the practice of primary care physicians and pulmonary specialists.
Methods
The period of study was from January 1991 to December 1992. Data were retrospectively collected by correspondence with physicians in departments of intemal medicine, dermatology. ophthalmology and neurology of the hospitals having more than 100 beds using retuming postcards In confimed and suspicious cases of sardoidosis, case record chart for c1 inical and laboratory findings were obtained in detail.
Results
1) Postcards were sent to 523 departments in 213 hospitals. Internal medicine composed 41% , dermatology 20% , ophthalmology 20% and neurology 19%. 2) Postcards were retumed from 241 departments (replying rates was 48%). 3) There were 113 confirmed cases from 50 departments and 10 cases. The cases were composed from internal medicine (81%). dermatology (13%). ophthalmology (3%) and neurology (3%). 78 confirmed cases were analysed, which were composed from department of internal medicine (92%), dermatology (5%) , and neurology (3%) 4) The time span for analysed cases was 1980 to 1992. one case was analysed in 1980 and the number gradually increased to 18 cases in 1991. 5) The majority of patients (84.4%) were in the age group of 20 to 49 years. 6) The ratio of male to female was 1 : 1.5. 7) The most common chief complains were respiratory symptoms. dermatologic symptoms, gener alized discomforts. visual changes. arthralgia , abdominal pains, and swallowing difficulties in order. 16% of the patients were asymptomatic. 8) Mean duration between symptom onset and diagnosis was 2 months 9) The most common symptoms were respiratory. general, dermatologic, ophthalmologic, neurologic and cardiac origin in order 10) Hemoglobin, hematocrits and platelet were in normal range. 58% of the patients had lymphopenia measuring less than 30% of white cell count. The ratio of CD4 to CD8 lymphocytes was 1.73± 1.16 with range of 0.43 to 4.62. ESR was elevated in 43% of the cases. 11) Blood chemistry was normal in most cases. Serum angiotensin converting enzyme (S.ACE) was 66.8±58.6 U/ L with the range of 8.79 to 265 U/ L. Proteinuria of more than 150 mg was found in 42 9% of the patients 12) Serum IgG was elevated in 43.5%. IgA in 45.5%. IgM in 59.1% and IgE in 46.7%. The levels of complement C3 and C4 were in the norrnal range. Anti-nuclear antibody was detected in 11% of the cases. Kweim test was perforrned in 3 cases, and in all cases the result was positive 13) FVC was decreased in 17.3%, FEV1 in 11.5% , FEV1 / FVC in 10% , TLC in 15.2% , and DLco in 64.7%. 14) Pa02 was decreased below 90 mmHg in 48.6% and PaC02 was increased above 45 mmHg in 5 7%. 15) The percentage of macrophages in BAL fluid was 51.4±19.2% , lymphocytes 44 .4± 21.1%, and the ratio of CD4 to CD8 lymphocytes was 3.41± 2.07. 16) There was no difference in laboratory findings between male and female 17) Hilar enlargement on chest PA was present in 87.9% (bilaterally in 78.8% and unilaterally in 9 1%). 18) According to Siltzbach’s classification, stage 0 was 5% , stage 1 58.3% , stage 2 28.3% , and stage 38.3%. 19) Hilart enlargement on chest CT was present in 92.6% (bilaterally 76.4% and unilaterally in 16. 2%). 20) HRCT was done in 16 cases. The most common findings were nodules, interlobular thickening, focal patchy infiltrations in order. Two cases was norrnal finding. 21) Other radiologic examinations showed bone change in one case and splenomegaly in two cases. 22) Gallium scan was done in 12 cases. Radioactivity was increased in hilar and mediastinal lymph nodes in 8 cases and in parenchyme in 2 cases 23) The pathologic diagnosis was commonly performed by transbrochial lung biopsy (TBLB, 47. 3%), skin and mediastinal lymph nodes biopsy (34 .5 %), peripheral lymph nodes biopsy (23.6%). open lung biopsy (18.2%) and bronchial biopsy in order 24) The most common findings in pathology were non-caseating granuloma (100%), multi-nucleated giant cell (47.3%) , hyalinized acellular scar (34.5%) , reticulin fibrin network (20%). inclusion body (10. 9%), necrosis (9.1%), and lymphangitic distribution of granuloma (1.8%) in order.
Conclusions
Clinical, laboratory, radiologic and pathologic findings were summarized. This collected data will assist in finding a test for detection and staging of sarcoidosis in Korea in near future.


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