Clinical bronchiectasis complicating pulmonary sarcoidosis: case series of seven patients

Abstract

Background and aim of work: 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.