title: Differences in symptom severity and health status impairment between patients with pulmonary and pulmonary plus extrapulmonary sarcoidosis.
abstract: BACKGROUND
  Although sarcoidosis most commonly affects the lungs, it is a multisystemic disease that often involves other organs. In this study, we compared fatigue, dyspnea, and the impact upon the activities of daily living and health status scores between patients with isolated pulmonary and pulmonary plus extrapulmonary sarcoidosis.
  
  
  METHODS
  In this cross-sectional study, we investigated 81 biopsy proven sarcoidosis patients. Fatigue was assessed by the standardized Fatigue Scale (FS). Dyspnea was determined by the Baseline Dyspnea Index (BDI) and the Modified Medical Research Council (MRC) Dyspnea Scale. Activities of daily living were assessed with the List of Daily Activities (DAL). Health status was measured by two standardized questionnaires: a generic measure--fifteen-dimensional measure of health-related quality of life (15D), and a respiratory-specific measure--St George's Respiratory Questionnaire (SGRQ). Patients were excluded if they had an associated illness that could influence their health status.
  
  
  RESULTS
  Statistically significant differences were demonstrated between the isolated pulmonary group and the pulmonary plus extrapulmonary group for fatigue (FS-total score: 2.4+/-0.64 vs. 2.8+/-0.62, p=0.007), dyspnea (BDI: 8.45+/-2.44 vs. 5.92+/-1.84, p<0.001; there was no statistically significant difference in MRC), activities of daily living (DAL: 4.33+/-2.93 vs. 5.87+/-2.40, p=0.014), and health status (SGRQ-total score: 33.07+/-22.81 vs. 43.69+/-21.55, p=0.04).
  
  
  CONCLUSIONS
  There are significant and clinically relevant differences in the severity of symptoms, restrictions of activities of daily living and impairment of health status between the patients with isolated pulmonary and pulmonary plus extrapulmonary sarcoidosis. Patients with pulmonary plus extrapulmonary sarcoidosis are more impaired in all these categories.
authors.affiliation: AbC.R.O. Inc. Serbia, 2 Ljnbostinjska Street, 11000 Belgrade, Serbia. bgvozden@verat.net
authors.forename: Branislav S
authors.initials: BS
authors.lastname: Gvozdenovic
authors.forename: Violeta
authors.initials: V
authors.lastname: Mihailovic-Vucinic
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Ilic-Dudvarski
authors.forename: Vladimir
authors.initials: V
authors.lastname: Zugic
authors.forename: Marc A
authors.initials: MA
authors.lastname: Judson
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000503:physiopathology*; D005221:Fatigue / Q000503:physiopathology*; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology*; D011788:Quality of Life; D012507:Sarcoidosis / Q000150:complications / Q000503:physiopathology*; D017565:Sarcoidosis, Pulmonary / Q000150:complications / Q000503:physiopathology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult