Sarcoidose: Uma série de casos e revisão de literatura

Abstract

Sarcoidosis is a multisystemic granulomatous disease that affects the lungs in most cases, but often involves other tissues making the clinical diagnosis challenging. In this work, we report a series of cases of patients diagnosed with sarcoidosis treated at the University Hospital Lauro Wanderley (HULW) in the period from 2015 to 2021 and who presented varied clinical manifestations of the disease. In order to describe the case series of Sarcoidosis in this service and gather data that support the diagnosis, we discuss the main clinical and epidemiological findings, as well as those demonstrated through complementary exams, comparing them with the data present in the current literature. The information of 9 patients was reviewed, 6 of which were female (fi = 66.6%) and 3 were male (fi = 33.3%). The age distribution was not significantly different between men and women (U = 7,000; p = 0.714; α = 5%) as well as the proportion of involvement between the sexes (p = 0.508; α = 5%), although it was possible to notice a trend towards the female sex. Respiratory symptoms were the most reported, affecting 5 patients (fi = 55.5%); the lung being the organ most frequently involved (ni = 8; fi = 88.8%). From the chest CT scans, perihilar or mediastinal involvement was verified in the vast majority of cases (ni = 5; fi = 55.5%), followed by nodular or micronodular pulmonary infiltrate (ni = 4; fi = 44.4 %) and pleural thickening (ni = 2; fi = 22.2%). Regarding the results of spirometry, restrictive ventilatory disorder was the only change described, occurring in 50% of cases and with a similar distribution of ages regardless of lung function (U = 2,500; p = 0.114; α = 0.05). In addition, there were no significant differences regarding the severity of pulmonary restriction in relation to gender (U = 5,000; p = 0.857; α = 5%). Based on the observed results, it can be seen that patients with sarcoidosis have varied clinical manifestations. Pulmonary and skin involvement is common, as well as respiratory symptoms that may warn of a possible restrictive impairment of lung function. The diagnosis of the disease is made by a combination of clinical, radiological and histopathological findings, being spirometry of great importance because it allows to assess the severity of respiratory impairment and to monitor the course of the disease