THE KVEIM-SILTZBACH TEST IN SARCOIDOSIS

BACKGROUND: The Kveim-Siltzbach test has been widely used in the diagn osis of sarcoidosis. This reactive is currently available in the autho rs' hospitals, Previous experience with this test in the same centers was reviewed to know its diagnostic usefulness. The present is the fir st series described in Spain. METHODS: From 1977 to 1988 the Kveim-Sil tzbach test was performed in 79 patients diagnosed or suspected of hav ing sarcoidosis. The study was carried out as cooperation of the valid ation process of sarcoid spleen suspensions (lots K12, K12 1/2, K32, K 41, K42, K42 1/2 and K50 of the Colindale antigen) prepared in the Sta ndards Laboratory for Serological Reagents in the Royal Brompton Hospi tal in London. RESULTS: The results of test positivity were determined following the criteria established by Siltzbach. The global sensitivi ty of the Kveim-Siltzbach test was 78% (CI 95% = 67.8-86.9). Positivit y ranged from 84% in subacute sarcoidosis to 61% in chronic sarcoidosi s (p = 0.08). Likewise, it was higher in patients with radiologic stag e I (84%) and II (81%) with respect to stage III (62%) or the cases wi th exclusive extrathoracic sarcoidosis (stage 0) (57%) (p = 0.11). No association was found between the Kveim-Siltzbach test positivity and the elevation in serum values of the angiotensin-converting enzyme (p = 0.575).CONCLUSIONS: In the present study the Kveim-Siltzbach test sh owed high sensitivity in the diagnosis of sarcoidosis. This fact, toge ther with the high specificity observed in other studies, makes the te st a very useful tool for the non-invasive diagnosis of sarcoidosis.