CLINICAL FACTORS PREDICTING PERSISTENCE OF ACTIVITY IN SARCOIDOSIS - A MULTIVARIATE-ANALYSIS OF 193 CASES

The prognosis of sarcoidosis is difficult to establish and it depends mainly on the persistence of activity over time and the degree of func tional impairment of the involved organs. The aim of this study was to identify factors predicting persistence of disease activity at diagno sis. In a 14-year period (1974-1987), 209 patients were diagnosed with sarcoidosis at Bellvitge Hospital, a 1,000-bed teaching institution i n Barcelona, Spain. One hundred ninety-three patients were followed up and included in the study. Clinical and radiological data were collec ted at diagnosis and a definition of disease activity was established. A Cox proportional-hazards regression model identified the following variables as independently influencing the persistence of activity: ab sence of erythema nodosum (risk ratio, RR = 2.37; 95% confidence inter val, CI: 1.54-3.66), pulmonary infiltrates in chest x-ray (RR = 1.89, 95% CI: 1.28-2.8), splenomegaly (RR = 3.67, 95% CI: 1.46-9.23), age gr eater than or equal to 40 years (RR = 1.01, 95% CI: 1.006-1.03), and a bsence of lymphadenopathy in chest x-ray (RR = 2.26, 95% CI: 1.08-4.77 ). We suggest that the identification of factors predicting persistenc e of sarcoidosis activity at diagnosis may help to establish the progn osis of the disease and therefore improve the therapeutic approach.