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SARCOIDOSIS: Marc A. Judson, Kathryn Hirst, Sudha K. Iyengar, Benjamin A. Rybicki, Laure El Ghormli, Robert P. Baughman, James F. Donohue, Robert C. Elston, Mani S. Kavuru, David R. Moller, Lee S. Newman, David L. Rabin, Milton D. Rossman, Alvin S. Teirstein, Michael C. Iannuzzi for the SAGA Study Consortium Comparison of Sarcoidosis Phenotypes Among Affected African-American Siblings Chest 2006; 130: 855-862 [Abstract] [Full text] [PDF]

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A voyage of discovery with an old map.

Roger K.A. Allen   (16 September 2006)

A voyage of discovery with an old map. 16 September 2006
Roger K.A. Allen, Thoracic and Sleep Physician Wesley Hospital, Auchenflower, Brisbane, Australia Send letter to journal: Re: A voyage of discovery with an old map. rogerallen{at}internode.on.net Roger K.A. Allen	Hepatic involvement in sarcoidosis is so common as to occur in essentially all cases. It is usually mild, subclinical, not often proven clinically by liver biopsy and liver function tests are usually normal. This is based on my experience in Australians (all white and approximately one thousand subjects over nearly 30 years). It is also worth noting that the liver involvment in sarcoidosis rarely leads to cirrhosis. How was liver involvement established and excluded? Hepatomegaly alone is a very crude yardstick. Ocular involvement must be sought prospectively and is a variable feast of pathologies from the front to the back of the eye with lacrimal involvement and dry eyes accounting for about 20-25% of patients in my experience. Serious eye involement is often asymptomatic at least initially. Therefore "ocular" involvement needs to be defined better. As a non-geneticist,I suspect that the word "eye" is not in the genetic biological dictionary but more probably some part of the eye eg retina to the lacrimal gland and even optic tracts. With regards lung function data, this is crude data with both obstructive and restrictive defects from sarcoidosis as well as a confusing interplay of smoking, COPD and asthma in the background in many subjects. It therefore does not surprise me than this study dominated by pulmonologists led to no conclusions. There was too much "fuzz" in the data for this to succeed unfortunately.