Airway responsiveness in sarcoidosis.

The purpose of this study was to measure airway responsiveness in patients with sarcoidosis using bronchoprovocation test with methacholine (BPT) in comparison to roentgenographic findings, respiratory symptoms, activity and duration of the disease. There were 17 patients with Sarcoidosis, 20 asthmatics and 21 assymptomatics. We used the tidal breathing method with standardizes output for the nebulizers. We administered increasing and successively concentrations of methacholine beginning with 0.125 to 16 mg/ml. The responses were measured by changes in FEV1 or the final concentration was reached. The results were expressed as the concentration of methacholine causing 20% fall in FEV1 (PC20). Aerosolized bronchodilator was given at the completion of all tests. There were 4 patients with sarcoidosis who had positive BPT, 3 of them with PC20<8 mg/ml associated with respiratory symptoms, bilateral hilar adenopathy, more than two-year duration and active disease. All the asthmatic subjects had positive BPT with CP20<8 mg/ml. The entire assymptomatic group had negative BPT. Positive bronchodilator response was reached in 6 patients with sarcoidosis, 20 asthmatics and 8 assymptomatic subjects. We concluded that: (a) airway responsiveness can be reached in 17.6% patients with sarcoidosis related to bilateral hilar adenopathy, chronic and active disease; (b) 50% of sarcoidosis patients with cough and/or wheeze had positive BPT, (c) the BPT was able to discriminate asthmatic from assymptomatic subjects.