Clinical observation of the significance of peripheral blood eosinophilia in pulmonary sarcoidosis

doi:10.3969/j.issn.1006-7795.2020.03.028

Abstract

Abstract: Objective To investigate the clinical significance of peripheral blood eosinophilia in patients with pulmonary sarcoidosis. Methods The clinical data of patients with treatment-naïve pulmonary sarcoidosis admitted to Beijing Tongren Hospital from January 2004 to January 2018 were selected as study subjects. According to the percentage and number of eosinophils in peripheral blood, the patients were divided into two groups:peripheral blood eosinophilia group (PBE group) and non-peripheral blood eosinophilia group (non-PBE group). There were 21 cases in PBE group and 24 cases in non-PBE group. The general data were compared and analyzed, which include clinical manifestations, extrapulmonary involved organs, laboratory results, lung function, bronchoalveolar lavage fluid(BALF) cell count classification, chest imaging features of the two groups. The therapeutic regimen and prognosis of the disease were followed up. Results The percentage of patients with nodular pattern and patchy consolidation in PBE group was higher than that in non-PBE group (80.95% vs 50%, 57.14% vs 25.0%; P<0.05). There were 14 patients in PBE group and 17 patients in non-PBE group were treated with systemic glucocorticoid,respectively. After one week of glucocorticoid treatment, the value of eosinophils in peripheral blood of the two groups was significantly lower than that before treatment (P<0.05). 16 patients in PBE group and 23 patients in non-PBE group completed follow-up,with a median follow-up time was 23.5 months and 21 months, respectively. Compared with non-PBE group, PBE patients were more prone to relapse (31.25% vs 4.35%, P<0.05). The peripheral blood eosinophil levels in the recurrent patients were significantly higher than that after one week of glucocorticoid treatment in PBE group. Conclusion Pulmonary active lesions of sarcoidosis are more common in patients with peripheral blood eosinophilia,as well as the recurrence rate of the disease is higher. It is necessary to closely monitor the condition of this kind of patients during therapy and follow-up.

Key words: sarcoidosis, eosinophils, radiology, therapy, prognosis

CLC Number:

R563

Sheng Haiyan, Liu Xiaofang, Jin Jianmin, Xu Jie, Liu Yong. Clinical observation of the significance of peripheral blood eosinophilia in pulmonary sarcoidosis[J]. Journal of Capital Medical University, 2020, 41(3): 475-481.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2020.03.028

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2020/V41/I3/475

References

[1] Hunninghake G W, Costabel U, Ando M, et al. ATS/ERS/WASOG statement on sarcoidosis. American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and Other Granulomatous Disorders[J]. Sarcoidosis Vasc Diffuse Lung Dis,1999,16(2):149-173.
[2] 中华医学会呼吸病学分会间质性肺疾病学组,中国医师学会呼吸医师分会间质性肺疾病工作委员会.中国肺结节病诊断和治疗专家共识[J].中华结核和呼吸杂志,2019,42(9):685-693.
[3] Renston J P, Goldman E S, Hsu R M, et al. Peripheral blood eosinophilia in association with sarcoidosis[J]. Mayo Clin Proc,2000,75(6):586-590.
[4] Akuthota P, Weller P F. Eosinophils and disease pathogenesis[J]. Semin Hematol,2012,49(2):113-119.
[5] Takahashi T, Azuma A, Abe S, et al. Significance of lymphocytosis in bronchoalveolar lavage in suspected ocular sarcoidosis[J]. Eur Respir J, 2001,18(3):515-521.
[6] Criado E, Sanchez M, Ramirez J, et al. Pulmonary sarcoidosis:typical and atypical manifestations at high-resolution CT with pathologic correlation[J]. Radiographics,2010,30(6):1567-1586.
[7] Takahashi A, Konno S, Hatanaka K, et al. A case of sarcoidosis with eosinophilia in peripheral blood and bronchoalveolar lavage fluid[J]. Respir Med Case Rep,2013,8:43-46.
[8] Nunes H, Uzunhan Y, Gille T, et al. Imaging of sarcoidosis of the airways and lung parenchyma and correlation with lung function[J]. Eur Respir J,2012,40(3):750-765.
[9] 董会帅,范崇渝,韩云.肺叶切除与肺段切除治疗肺部磨玻璃结节效果的比较[J].中国医科大学学报,2019,48(6):547-550.
[10] Schildge J, Klar B. Pulmonary sarcoidosis-clinical and bronchoscopic findings in relation to the radiographic stage[J]. Pneumologie,2005,59(9):582-587.
[11] Mochizuki I, Kobayashi T, Wada R, et al. Vascular lesions in the biopsied bronchus of patients with sarcoidosis changes of the endothelial cells in aggregation of eosinophils[J]. Sarcoidosis,1990,7(1):35-41.
[12] Ziegenhagen M W, Rothe M E, Schlaak M, et al. Bronchoalveolar and serological parameters reflecting the severity of sarcoidosis[J]. Eur Respir J,2003,21(3):407-413.
[13] 赵界,何正光,杨艳,等.糖皮质激素吸入治疗对支气管哮喘急性发作患者血清IL-5和IL-10的影响[J].解放军医药杂志,2017,29(3):62-64,72.
[14] Sharma S K, Mohan A, Guleria J S. Clinical characteristics, pulmonary function abnormalities and outcome of prednisolone treatment in 106 patients with sarcoidosis[J]. J Assoc Physicians India,2001,49:697-704.
[15] 冷冬,李桂芹,王颖,等.肺纤维化风险预测的临床生物化学模型[J].首都医科大学学报,2019,40(6):875-880.