Prognosis of Intrathoracic Sarcoidosis in England

Abstract

Early in 1960 I surveyed the records of 230 patients with sarcoidosis whom I had first seen up to the end of the previous year, with special reference to the role of Mycobacterium tuberculosis in aetiology, and in discus- sing them described the diagnostic criteria adopted (Scadding, 1960).A total of 136 first came under my observation before the end of June, 1955, and in the autumn of 1960 1 endeavoured to complete the review of this group, first seen five years or more previously, by obtaining information about the current state of those among them who had passed out of my super- vision.This paper describes the result of this review, with special reference to prognosis in relation to the intrathoracic changes.The patients were first seen with various types of intrathoracic change, and at widely differing intervals after the probable time of onset of sarcoidosis.An earlier review of them (Scadding, 1956) had suggested that prognosis might be related to the type of intra- thoracic change then found, even among those who showed no evidence of fibrosis at that time.For these reasons-I have divided the patients into four groups according to the type of change in the chest radiograph when I first saw them:Group 1: 32 patients; enlarged hilar lymph-nodes only.Group 2: 40 patients; mottled shadowing in the lungs with enlarged hilar lymph-nodes, either present or known to have been present in the past.Group 3: 37 patients; mottled shadowing in the lungs, without present or available past evidence of enlargement of hilar lymph-nodes.Group 4: 27 patients; radiographic and clinical features suggesting fibrosis, usually in addition to mottled shadowing.