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Tuesday, May 21, 2013
How Many Stages Does Sarcoidosis Have?
I’ve had sarcoidosis since 1995 until now, but had a really bad episode in 2002 and was in and out of the hospital. The doctor used Remicade. I read up on it and from what I read, the Prednisone is not working. I have it in my lungs and eyes still a little.
Dear Sir/Madam- This is an excellent question, which means that the answer is complex! The concept of sarcoidosis "stages" is a bit confusing.
Many years ago, radiologists characterized sarcoidosis based upon the typical patterns of disease observed on standard x-rays of the chest.
In general, higher x-ray stages conform to more severe lung disease; however, each patient does not necessarily progress through all of these radiographic stages.
Some sarcoidosis patients have normal chest x-rays (Stage 0) or only have enlarged lymph nodes in the chest (Stage 1) and never develop significant lung disease, while others present with very active lung disease (Stages II and III) or irreversible lung scarring (Stage IV).
Rather than attempting to classify the "stage" of sarcoidosis, it makes more sense to determine which organs are involved and how severe the consequences of the disease might be. This determines who requires treatment.
In cases like yours, where the disease progresses or remains active despite the usual first-line treatments (e.g., prednisone), it becomes necessary to switch to other treatments.
At present, we have no good test to determine which treatment is best for each individual. More research and new therapies are needed to improve the care of sarcoidosis patients.
Elliott D Crouser, MD
Associate Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University