Physiologic Abnormalities in Pulmonary Sarcoidosis

¹ Head, Chest Service and Cardiopulmonary Function Laboratory
² Staff, Chest Service

1. Pulmonary sarcoidosis produces a multitude of physiologic aberrations of pulmonary function, these seen even in patients with no evident parenchymal involvement, however, those with parenchymal involvement have more consistent and more severe abnormalities than those with mere node involvement.

2. The arterial oxygen tension, especially with exercise, alveolar-arterial oxygen tension gradient, maximum diffusion capacity, and physiologic dead space determinations appear to be finite tests to grade this physiologic abnormality.

3. Lung volumes, ventilation, intrapulmonary mixing, and mechanics of the airway seem relatively less affected by this disease process.

4. The abnormalities seem to be related mainly to abnormalities in the ventilation/perfusion relationships rather than changes in the alveolar-capillary membrane as once considered. Changes in the pulmonary capillary bed also seem to be related, but were not studied in this group.

5. Complete studies of the various parameters must be completely done, especially with exercise, to evaluate properly the patient with pulmonary sarcoidosis, whether he be symptomatic or not and whether there be parenchymal involvement by x-ray or not.