Sarcoidose no sul do Brasil : estudo de 92 pacientes

Abstract

Objetivo: Este estudo de casos do Rio Grande do Sul, Brasil, propõe-se a traçar um perfil local da sarcoidose, descrevendo as características dos pacientes, apresentação clínica, função pulmonar, achados radiológicos, histopatológicos e exames bioquímicos de uma série de casos, por ocasião do diagnóstico. Métodos: Estudo retrospectivo de 92 pacientes com sarcoidose, atendidos no Pavilhão Pereira Filho, da Santa Casa de Porto Alegre (RS), entre 1990 e 2003. O protocolo incluiu dados clínicos, bioquímicos, radiológicos, espirométricos e de biópsia. Resultados: Não houve diferença de freqüência entre homens e mulheres (42% e 58%, respectivamente). A média de idade foi de 41,8 ± 14,1 anos, situando-se 87% dos pacientes entre 20 e 60 anos. Houve predomínio em caucasianos (84%). Dados sobre tabagismo mostraram que 61% dos pacientes nunca fumaram, 29% eram ex-fumantes, e 10% ainda fumavam. O diagnóstico foi feito principalmente no inverno (33%). Dentre os dados clínicos destacaram-se: 12% eram assintomáticos, 18% tinham somente sintomas torácicos, 22% somente manifestações extratorácicas, e 48% apresentaram combinação de sintomas torácicos e extratorácicos. A espirometria foi realizada em 79% dos pacientes, no momento do diagnóstico, com resultados anormais em 45% deles, com os seguintes padrões: restritivo em 23%, obstrutivo em 18%, e misto em 4% deles. A distribuição dos tipos radiológicos mostrou 30% tipo I, 48% tipo II e 22% tipo III. Conclusão: Os achados desta série mostraram-se semelhantes aos descritos na literatura, particularmente na européia.

Objective: This case study, conducted in the state of Rio Grande do Sul (RS), Brazil, aims to determine the local profile of sarcoidosis, describing patient characteristics, clinical presentation and pulmonary function, as well as analyzing the results of radiological, histopathological and biochemical tests, at the time of diagnosis in a series of sarcoidosis patients. Methods: A retrospective study of 92 patients with sarcoidosis treated on the Pavilhão Pereira Filho (Pereira Filho [Respiratory Diseases] Ward) of the Hospital Santa Casa, in the city of Porto Alegre, RS, between 1990 and 2003. The protocol included the collection of clinical, biochemical, radiological, spirometric and histological data. Results: There was no significant gender-based difference in frequency (men, 42%; women, 58%). Mean age was 41.8 ± 14.1 years, with 87% of patients being between 20 and 60 years old. Caucasians predominated (84%). Most patients (61%) had never smoked, 29% were former smokers, and 10% were current smokers. The majority (33%) of the diagnoses were made in winter. Among the clinical findings, it is of note that 12% were asymptomatic, 18% presented pulmonary symptoms only, 22% presented extrapulmonary symptoms only, and 48% presented pulmonary and extrapulmonary symptoms. Spirometry was performed in 79% of patients at the time of diagnosis. In 45% of those patients, abnormal results were obtained: a restrictive pattern was seen in 23%, an obstructive pattern in 18% and a mixed pattern in 4%. Classification by radiological type revealed that 30% were stage I, 48% were stage II, and 22% were stage III. Conclusion: The findings of this study are quite similar to those of other studies in the literature, particularly those conducted in Europe.