Bychenko O. The efficiency of glucocorticosteroid therapy in patients with newly-diagnosed sarcoidosis with lung parenchyma damage

Object of study: patients with newly-diagnosed sarcoidosis with lung parenchyma damage; the aim – to study the effectiveness of glucocorticosteroid (GCS) therapy in patients with newly-diagnosed sarcoidosis with lung parenchyma damage basing on research of the incidence of serious side effects and cases of resistance, determining of factors of unfavorable prognosis of regression rates, incidence and possible causes of recurrences; methods of investigation: clinical, computed tomography of the chest (CT), spirometry, bodyplethysmography, diffusion lung capacity, analysis of ionized calcium blood level; the novelty: new data on the short-term and long-term results of GCS therapy, conducted without a previous observation period in patients with newly-diagnosed pulmonary sarcoidosis with asymptomatic debut were obtained; high efficacy of GCS therapy in the evaluation of its short-time results was observed, but at the same time, a high rate of relapses was detected during the first year after the completion of treatment; for the first time in patients with sarcoidosis with lung parenchyma damage, the incidence of contraindications for the appointment of GCS (12%), serious side effects requiring the discontinuation of the treatment (3%), and cases of resistance to GCS therapy (17%) during the standardized treatment were established; the most probable factors of the unfavorable prognosis concerning the rate of regression of sarcoidosis were determined; for the first time, it has been established that the presence of high-density dissemination (>–800 HU) and/or lung ventilation disorders in the debut of the disease is accompanied by decrease of the regression rate; it was proved that performing of computed tomographic densitometry of lung parenchyma on the last visit of the treatment period improves the quality of evaluation of the state of clinical recovery. Scope – medicine.