Source: Annual Congress 2006 - Sarcoidosis
Disease area: Interstitial lung diseases

Abstract

Objective: To investigate the frequency of smoking and its association with clinical or paraclinical data, in newly diagnosed pulmonary sarcoidosis.
Subjects and methods: 317 patients (age 38.4±11.7, 194 women) were prospectively investigated in 1998-2004 in our Institute, with chest X-ray, pulmonary function tests (volumes, flows, diffusion), serum angiotensin-converting enzyme (ACE), fiber-bronchoscopy with broncho-alveolar lavage (BAL).
Results: 82 patients (25.9%) were (ex)smokers. There were no differences between smokers and nonsmokers, by age, diagnosis delay or type of onset (p=NS). (Ex)smokers had significantly lower lung volumes (p=0.003), flows (p=0.001), and diffusion capacity (p=0.008), more BAL neutrophylls (p=0.009) and macrophages (p=0.015), less BAL lymphocytes (p=0.002), higher ACE values (p=0.001), and more parenchymal involvement on chest X-ray – stages II or III (p=0.001). Bronchial obstruction (recorded in 43 patients, 13.6%) was not associated with smoking (p=NS). Higher pack-year history (over 10) was associated with dyspnoea (p=0.003) and higher diagnostic delay (p=0.019).
Conclusion: Smoking in patients with newly diagnosed sarcoidosis was associated with a more serious condition: lower pulmonary function tests data, frequent interstitial involvement, higher BAL neutrophylls, but not with bronchial obstruction. Heavy smoking may delay the diagnosis of sarcoidosis by obscuring associated symptoms.

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D. Ionita, C. Cilt, N. Bisca, I. Balcu, D. Marta, R. Nemes, A. Macri, I. Strambu, C. Tudose, C. Toma, A. Serbescu, L. Cervis, I. P. Stoicescu (Bucharest, Romania). Smoking is associated with more serious forms of pulmonary sarcoidosis. Eur Respir J 2006; 28: Suppl. 50, 3140

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