Characteristics and outcomes of mediastinal and pulmonary sarcoidosis in Tunisian people

Sarcoidosis is a disease of unknown cause, and varies from mild to life-threatening. Our objective is to study the clinical, paraclinical and outcomes of mediastino-pulmonary sarcoidosis. This is a retrospective, descriptive and analytic study conducted over a 20-year period (January 2002 to December 2022). It compiled records of patients who were followed up for confirmed mediastino-pulmonary sarcoidosis. The study included 35 patients with a mean age of 56.69 ± 14.42. Male-to-female sex ratio was 0.346. The most common respiratory signs were dyspnea (82.9%) and dry cough (80%). Extra-respiratory symptoms were noted in 45.7% of cases, with the most common being polyarthralgia (28.6%), xerophthalmia (20%) and xerostomia (14.3%). The most common parenchymal lesions were micronodules (71.4%), and nodules (51.4%). The right upper lobe (77.1%) and middle lobe (74.3%) were the most. Hilar adenopathy (71.4%), and paratracheal adenopathy (60%) were the most frequent lymph node involvements. A restrictive ventilatory defect was noted in 32% of cases, obstructive ventilatory defect in 13%, and mixed ventilatory defect in 10%. Oral corticosteroids were initially administered in 60% of cases. Chronic respiratory failure was observed in 20% of cases. Factors significantly associated with an unfavorable outcome included hemoptysis (p=0.008), the need for systemic corticosteroid treatment (p=0.009), non-hypercapnic acute respiratory failure (p=0.05), and dilation of the right cavities identified by echography (p=0.002). The clinical phenotype of sarcoidosis can be extremely variable. CT scan plays an important role to diagnose and monitor the disease. Sarcoidosis is unpredictable and depends on the occurrence of complications.