Tuberculosis and Asthmatic Bronchitis in Sarcoidosis

Some Observations on 150 Cases of Besnier-Boeck-Schaumann Disease

¹ The Division of Pulmonary Diseases (Prof. Dr. N. G. M. Orie) and the Medical Department (Prof. Dr. F. S. P. van Buchem) of the State University, Gronigen, Netherlands.

The most remarkable features in our group of 150 patients with sarcoidosis selected on the basis of severity from ±700 patients observed during the same period in the same region were the following:

1. The high frequency of contact with open tuberculosis.

2. The calcification during the course of the disease.

3. The high frequency of asthmatic-bronchitis (asthmatic constitution) in cases with diffuse long-standing lesions of the third stage (43.7 per cent). This constitution seems to be partly responsible for the signs and symptoms and perhaps also for the chronic course of the disease in these patients and probably explains why in the severe diffuse cases men are predominant over women, the latter having a high frequency in the glandular type.

4. The relatively low frequency of infections of the respiratory passages (14 per cent). These are also largely found in the cases with a history of symptoms and an asthmatic constitution.

5. The favorable effect of the therapy with ACTH and corticosteroids both on the "asthmatic" factor and on the anatomical changes.

6. The occurrence of serious sequelae in 6 to 10 per cent of cases and mortality rate of 2 per cent (overall figure calculated on the 700 cases from which ours were selected).

7. The unfavorable prognosis in the cases with iridocyclitis.