Clinical bronchiectasis complicating pulmonary sarcoidosis: case series of seven patients.
OBJECTIVE
It has been known for years that pathological changes of bronchiectasis may be seen on tissue examination of the lungs in pulmonary sarcoidosis. However, the clinical picture that may develop as a result of these changes has been under-appreciated.


METHODS
We report seven patients with advanced stage IV pulmonary sarcoidosis in whom clinical bronchiectasis developed, seen in our university based pulmonary clinic between 1978 and 1999.


RESULTS
These patients frequently exhibited symptoms and signs that are uncommon in sarcoidosis - hemoptysis, recurrent infection, lung crackles and digital clubbing. The clinical course was worse than similar stage nonbronchiectatic sarcoidosis, with more frequent infections and a higher mortality rate.


CONCLUSIONS
Recognition of this subset of patients may improve management when complications arise. Therapy directed at bronchiectasis rather than aimed at suppressing putative continued sarcoidosis activity appears to be more important at this late stage of disease.
Lewis
Mary-Margaret
MM
Georgetown University Medical Center, Division of Pulmonary and Critical Care Medicine, Washington, DC 20007, USA.
Mortelliti
Michael P
MP
Yeager
Henry
H
Tsou
Edward
E
D000328:Adult; D001987:Bronchiectasis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D012129:Respiratory Function Tests; D017565:Sarcoidosis, Pulmonary / Q000150:complications* / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome