Versicherungsmedizin / herausgegeben von Verband der Lebensversicherungs-Unternehmen e.V. und Verband der Privaten Krankenversicherung e.V
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Versicherungsmedizin · Dec 1995
[Sarcoidosis. Dependence of life expectancy on lung function, respiratory symptoms, roentgenologic stage and age at diagnosis and significance of extrapulmonary manifestations].
Patients with intrathoracic sarcoidosis have - during prolonged observation (27 years) - the same survival as the general population. A higher mortality from sarcoidosis as well as from diseases not related to sarcoidosis is found among persons who at the time of diagnosis of sarcoidosis had respiratory symptoms and a low FEV1, TLC and Tiffeneau. Our knowledge of the prognosis for extrapulmonary manifestations and their influence on survival is sporadic. Symptoms from heart and CNS have in studies of selected patients been connected with an elevated mortality.
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Sarcoidosis is a frequent, systemic, granulomatous disorder with predominant involvement of the hilar lymph nodes and the pulmonary parenchyma. By bronchoalveolar lavage an activation of alveolar immune cells has been observed yielding a detailed concept of the immunopathogenesis of the disease from which new, clinically applicable staging parameters are delineated. There is some evidence that immunopathogenetic mechanisms determine the course and the prognosis of the disease.