[Influence of corticosteroid-therapy on the course of sarcoidosis (author's transl)]. / Influence de la corticothérapie sur l'évolution de la sarcoïdose.

The examinations relate to 206 patients suffering from a bioptically confirmed sarcoidosis, observed during 1959-1974. The observation period amounted to 2-15 years. The indications of the corticosteroid-therapy ran as follows: 1. in cases of a lymph node sarcoidosis without respiratory disorders, after a 2 years' observation without a regression. 2. in cases with pulmonary alterations already after 3-6 months without a regression. 3. in all cases of an extended pulmonary sarcoidosis. In the first group the sarcoidosis developed spontaneously in 65.2%, after a treatment in 15.7%. In 19.1% there was an unfavourable course, even in treated cases (2.2%). In the second group there was a spontaneous regression in 35.5%, after a treatment in 57%. In 10% the sarcoidosis changed over into the chronic form. The treatment failed in about 3%. In the third group we did not observe any spontaneous regression, after the corticosteroid-therapy a regression appeared in 35.7%. The condition remained unchanged in 64.3%. Totally there was a spontaneous regressions in 44.2% of the patients. Good results after the corticosteroid-therapy were attained in 36.4%, and the rest of about 20% developed to irreversible forms of the disease.

[2nd European Symposium on Sarcoidosis. Various methods of corticosteroid therapy]. / 2nd European Symposium on Sarcoidosis. Diverses méthodes de corticothérapie.

In order to achieve good results with the corticosteroid-therapy in not spontaneously regredient sarcoidoses a longterm treatment (12-24 months) by considerable corticosteroid-doses proves to be necessary; thereby the problem of side-effects by steroids will arise, especially in young women frequently developing a Cushing-syndrome. By our endeavour to prevent this unpleasant phaenomenon we carried through an alternating attempt with two variant kinds of intermittent treatment. The first method relates to 4 successive days in the week (as it is proposed by P. Krakowka) and the second procedure relates to each 2nd day. The second treatment has proved to be the better one. Side-effects appeared in 31. 9 per cent in case of a daily treatment by steroids, in 27.3 per cent after the application of the method of 4 days a week, and in no one case after an application each second day. The results of the treatment by corticosteroids are equal in all the three groups.

Sarcoidosis of the lung. Natural history and effects of treatment.

An analysis on the natural course of pulmonary sarcoidosis and effects of corticotherapy was carried out in 960 patients observed during 25 years (1959-1985). There were 434 males and 526 females in the studied group aged from 14 to 69 years, when entering the study. The time of follow-up ranged from 2 to 20 years. In 20% of subjects disease had an acute course, in the remaining 80% the process was symptomless, often of chronic nature. Majority of patients presented with stage I or stage II of the disease (respectively 48.2% and 48.6%). Histological confirmation was obtained in 70% of subjects. Spontaneous remission or improvement was observed in 62.2%. Remission or improvement following treatment was seen in another 18.7% (a beneficial effect being observed in 84.1% of treated patients). Altogether remission or improvement, spontaneous or after treatment, was seen in 80.9% of studied group. In the remaining 19.1%, 2.8% of whom were treated and 16.3% not treated, a progression of the pulmonary changes was observed-the disease evolved into chronic stage. In acute pulmonary sarcoidosis the evolution of the disease was more favorable. Remission or improvement, spontaneous or after treatment, was observed in 89.3% of patients, versus 76.3% of patients with symptomless course of the disease. Recurrence of the disease was observed in 21 cases. It was seen only in treated patients shortly after completion of treatment.

[The frequency and course of fibrotic changes in patients with sarcoidosis]. / Czestosc wystepowania i przebieg zmian wlóknistych u chorych na sarkoidoze pluc.

Basing on observations of 960 patients with pulmonary sarcoidosis the authors found fibrotic changes of pulmonary parenchyma in only a few, the incidence being 3.2. Improvement in radiological examination following steroid therapy was seen in 50%, of respiratory function in 30%. Although both examinations do not fully correlate with each other, they are however supplementary with each other, and should be regarded as important criteria of functional involvement and therapy outcome.