ABSTRACT
Mononuclear cells from patients with sarcoidosis respond to Kveim tissue suspensions in vivo and from granulomas. We attempted to develop an in vitro Kveim test by adding Kveim material to monocytes and lymphocytes from patients with sarcoidosis and observing the cells in tissue culture. Sarcoid leukocytes were grown in culture with either Kveim suspensions (100 microgram/ml), control human spleen extract (100 microgram/ml) or no foreign antigen. After 7 to 9 days, we counted the number of cells adherent to glass, the number of cells with nucleoli, and the number of giant cells. Despite equal monocyte inocula, cultures of sarcoid leukocytes consistently had more cells adherent to glass than did cultures from normal donors regardless of whether Kveim, spleen, or no antigen was added to the cultures. There were no significant differences in giant cell formation or in the number of cells with nucleoli in the sarcoid compared with the control cultures.
Subject(s)
Kveim Test , Leukocytes , Sarcoidosis/diagnosis , Skin Tests , Cell Nucleolus , Cells, Cultured , Humans , Lymphocytes , Macrophages , Monocytes , Time FactorsABSTRACT
The two-stage leukocyte migration agarose test (indirect LMAT), shown to be a sensitive in vitro assay for cell-mediated immunity, was used to study Kveim reactivity in vitro in patients with sarcoidosis. No Kveim-induced inhibition of leukocyte migration in agarose or Kveim-induced lymphocyte transformation in vitro was found in 23 patients with sarcoidosis, suggesting that the Kveim reaction is not an expression of cell-mediated immunity.
Subject(s)
Leukocytes/immunology , Sarcoidosis/immunology , Adult , Cell Migration Inhibition , Female , Humans , Immunity, Cellular , Kveim Test , Lymphocyte Activation , Lymphocytes/immunology , Male , Middle AgedABSTRACT
Pulmonary function tests in 25 newly studied patients with Stage I and 19 with Stage II sarcoidosis revealed normal mean values in Stage I for all tests except DLCOSB. Mean values for VC, TLC, MMF, and exercise Pao, were abnormal in Stage II and significantly different from Stage I. There was a parallel difference in prevalence of impairment of these measurements and of DLCOSB as well. When the present results are compared with previously reported values for sarcoidosis patients with radiographic evidence of pulmonary fibrosis, progressive impairment is evident with later stages of disease. These findings indicate that extent and prevalence of impairment increase with progressive radiographic abnormality and that physiologic findings are useful in staging sarcoidosis.
Subject(s)
Lung Diseases/physiopathology , Lung/physiopathology , Sarcoidosis/physiopathology , Airway Resistance , Carbon Monoxide , Forced Expiratory Volume , Humans , Maximal Midexpiratory Flow Rate , Oxygen/blood , Pulmonary Diffusing Capacity , Sarcoidosis/pathology , Smoking/complications , Vital CapacitySubject(s)
Sarcoidosis , Adrenal Cortex Hormones/therapeutic use , Adult , Eye Diseases/etiology , Female , Humans , Lymph Nodes , Male , Prognosis , Retrospective Studies , Sarcoidosis/diagnosis , Sarcoidosis/drug therapy , Sarcoidosis/pathology , Skin Tests , Thoracic Diseases/diagnosis , Thoracic Diseases/drug therapy , Thoracic Diseases/pathology , Tuberculin TestABSTRACT
Caucasians in this study group presented in the chronic stage of sarcoidosis more frequently than the Blacks and Puerto-Rican-born. 2) Twenty-eight percent of the Caucasians and 26% of the Blacks who presented in the chronic stage of sarcoidosis, died of pulmonary insufficiency. 3) Puerto-Rican-born women are especially prone to present with erythema nodosum and Stage I radiographic sarcoidosis. 4) Sarcoidosis with extrathoracic organ involvement was more common in Black and Puerto-Rican-born patients than in Caucasians. 5) The size of the Kveim papules was larger in the Black and Puerto-Rican-born patients than among the Caucasians. 6) Two-thirds of all groups were insensitive to tuberculin. 7) The extent and duration of disease at presentation is a major determinant prognosis. 8) Ethnic factors influence the clinical patterns in sarcoidosis, but socioeconomic factors may preclude generalizations based solely upon clinic populations in New York City.
Subject(s)
Sarcoidosis , Black People , Chronic Disease , Humans , Kveim Test , New York City , Prognosis , Puerto Rico/ethnology , Radiography , Sarcoidosis/diagnosis , Sarcoidosis/diagnostic imaging , Time Factors , Tuberculin Test , White PeopleABSTRACT
1) Twenty of 25 patients (80%) with sarcoidosis had positive lung biopsies obtained by flexible-bronchoscope biopsy. 2) Three of the 5 negative biopsies were in patients with chronic sarcoidosis whose chest radiograph was unchanged for 1 yr or more. 3) Two insignificant pneumothoraces occurred as a complication of the bronchoscopic biopsy procedures. 4) Noncaseating epithelioid-cell granulomas found on fiberoptic bronchoscopic biopsy are no more specific for the diagnosis of sarcoidosis than similar findings in any other organ biopsy.
