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We examined serum angiotensin converting enzyme (ACE), serum lysozyme, serum immunoglobulin (IgG), tuberculin test, bronchoalveolar lavage (BAL) examination, and Gallium scintigraphy in 516 histologically proven Sarcoidosis patients with epithelioid cell granulomas (150 patients in Stage 0, 256 in Stage 1, 86 in Stage 2, and 24 in Stage 3) at the time of diagnosis and analyzed their positive rates. In BAL examinations, positive results mean BAL lymphocytosis and/or high CD4/CD8 ratios. In 516 sarcoidosis patients, the positive rates found were: serum ACE (49.8%), lysozyme (51.7%), IgG (13.8%), negative tuberculin test (69.2%), abnormal BAL findings (86.0%), and high uptake of Gallium scintigraphy (82.2%). High positive rates were found for ACE, lysozyme, tuberculin test, BAL and Gallium scintigraphy in Stage 1 and Stage 2, while that of IgG was very low. In Stage 0, those of ACE, lysozyme, and IgG were low, whereas those of tuberculin test, BAL, and Gallium scintigraphy were over 50%. In Stage 3, those of ACE, and IgG were significantly lower than Stage 1 and Stage 2. In Stage 0 and Stage 3, the positive rates of several examinations were significantly lower than those in Stage 1 and Stage 2. In Stage 0 and Stage 3, histological proof of epithelioid cell granulomas is required for diagnosis of sarcoidosis.
日本サルコイドーシス/肉芽腫性疾患学会の論文