Gülhan Ayhan ALBAYRAK
Anatolian Current Medical Journal - 2026;8(1):103-110
Aims: Pulmonary exacerbations of sarcoidosis (are associated with increased morbidity, treatment escalation, and worse long-term outcomes. However, reliable predictors for exacerbations remain unclear. This study aimed to identify clinical, laboratory, and radiological factors associated with pulmonary exacerbations of sarcoidosis and to determine potential early predictors of exacerbations. Methods: A retrospective cohort study was conducted on 107 patients diagnosed with pulmonary sarcoidosis within the past five years. Patients were categorized into an exacerbation group (n=57) and a non-exacerbation group (n=50). Exacerbation was defined as worsening of respiratory symptoms and/or radiological findings lasting >=14 days, with no alternative acute underlying causes such as infections or irritant exposure. Demographic data, environmental exposures, results of pulmonary function tests (PFTs), and six-minute walk test (6MWT), systolic pulmonary arterial pressure (PAP), laboratory parameters, treatment regimens, and high-resolution computed tomography (HRCT) findings were analyzed. Results: Pulmonary exacerbations of sarcodosis were seen in 27.5% of our cases. Significant differences were found between groups in terms of extrapulmonary organ involvement, recurrent acute respiratory infections, environmental exposure, disease stage, PAP , PFT results, urinary calcium levels, and corticosteroid use (p<0.05). HRCT showed more severe parenchymal damage and fibrosis in the exacerbation group (p=0.005). In multivariate analysis, frequent acute respiratory infections were identified as the strongest independent predictor of pulmonary exacerbations (OR=5.166, p=0.002). Conclusion: Pulmonary exacerbations of sarcoidosis have a multifactorial etiology, with recurrent respiratory infections being a strong independent predictor. HRCT findings, particularly parenchymal damage and fibrosis, provide significant prognostic value. Early identification of high-risk patients may enable timely interventions and improved management.
