Are there any predictors of MTX response in progressive pulmonary sarcoidosis?
Chronic sarcoidosis is marked by the heterogeneity of clinical phenotypes. Some patients may enter spontaneous remission without medication, in others the disease progress despite therapy. While there is no cure for sarcoidosis, immunosuppression is often employed to control inflammation, although the clinical response is variable.Objective: to analyze patients clinical characteristics, inflammatory findings that point to those individuals who will most likely respond to treatment.Methods: in a cohort of 50, previously described MTX treated, chronic sarcoid patients (1) we compared the initial clinical status (sex, age, disease duration, smoking habits, radiological picture) and disease activity (RBC, WBC, CRP, Ca, P serum levels, proteinogramme, ddimers, fibrinogene, serum and BAL TNFα, TGFβ, IL2, IL2R, IL12, IL10 levels) between MTX responders vs MTX nonresponders groups.Results: No association with patient clinical status was found. Predictors of MTX response were high serum albumins (52,8 vs 48,9, p
ConclusionEPS may help with risk stratification in patients with CS and abnormal imaging, especially those without conventional indications for ICD placement. Among patients with LVEF>35% and no history of prior VA, a negative EPS has good positive and negative predictive value for future VA events.
Authors: Boutagy NE, Feher A, Alkhalil I, Umoh N, Sinusas AJ Abstract Multimodality cardiovascular imaging is routinely used to assess cardiac function, structure, and physiological parameters to facilitate the diagnosis, characterization, and phenotyping of numerous cardiovascular diseases (CVD), as well as allows for risk stratification and guidance in medical therapy decision-making. Although useful, these imaging strategies are unable to assess the underlying cellular and molecular processes that modulate pathophysiological changes. Over the last decade, there have been great advancements in imaging instrumenta...
Authors: Toussirot E, Bernard C, Bossert M Abstract PMID: 30873944 [PubMed - as supplied by publisher]
We present a series of patients with sarcoidosis associated PH and describe correlation between the pre-transplant hemodynamic data from a right heart catheterization (RHC) and vascular morphologic changes in the native explanted lungs.
Clinical findings of cardiac sarcoidosis are evident in only about 5% of patients with sarcoidosis however approximately 20% of autopsies demonstrate myocardial involvement. The epidemiology and prognosis of cardiac sarcoidosis remains poorly understood.
Cardiac sarcoidosis is a potentially reversible etiology of heart failure if identified and managed in a timely fashion. Given the multisystem nature of the disease and need for a high index of suspicion, diagnosis of cardiac sarcoidosis is difficult, and the underlying cause remains speculative.
To investigate outcome of patients with giant cell myocarditis (GCM) or cardiac sarcoidosis (CS) who undergo heart transplantation (HTx) or implantation of mechanical circulatory support (MCS).
we recently read with interest the case series on the novel disease entity of combined sarcoidosis and idiopathic pulmonary fibrosis (IPF/UIP) identified by Raghu et al. and defined as CSIPF (1). The association of these interstitial lung diseases (ILD) with different ethiopathogenesis and clinical course in a single patient is a real rare event, and the above description of 25 patients raises the question whether this association represents a mere coincidence or a novel phenotype consequent to a genetic undefined mutation.
ConclusionsThis study provided useful information that the relapse and associated risk factors should be taken into considerations when determining treatment strategies for patients with pulmonary sarcoidosis.
We reported a patient with a history of heavy smoking with particular image features of CD, which presented as mediastinal lymphadenopathy and peribronchovascular interstitial thickening mimicking lung cancer or sarcoidosis initially. Castleman's disease (CD) is an uncommon lymphoproliferative disorder characterized as either unicentric or multicentric presentation based on the involving sites. The most frequent presentation of CD is a solitary mediastinal mass. We reported a patient with a history of heavy smoking with particular image features of CD, which presented as mediastinal lymphadenopathy and peribronchovascular ...