| Abstrakt: |
The natural history of sarcoidosis was analyzed in 279 patients with its history of as long as 2 years among the 832 with this disease registered in the Republic of Tatarstan in 1999 to 2002. The patients were divided into 3 groups: (1) 79 (28.3%) receiving systemic glucocorticosteroids (SGS); (2) 146 (52.3%) patients having therapy without SGS; (3) 54 (19.3%) patients receiving no drug therapy, but they were followed up by a physician. There was no strong evidence for that it was expedient to use prednisolone in most of patients. Prednisolone exerted a significant effect on clinical manifestations, laboratory values, and radiation pattern in patients with sarcoidosis, but more commonly (28.9%) led to its relapses than alternative treatment and active follow-up. Patients treated with prednisolone and other drugs and those untreated showed no significant differences in the frequency of cases of a worse X-ray pattern during 28 years. It is advisable to follow an active observation policy in patients having a stable course of sarcoidosis, by restricting indications for the use of prednisolone in those who have apparently progressive or threatening extrapulmonary manifestations of the disease (heart, nervous system, eyes). |
