Delays in diagnosis in patients with pulmonary and extrapulmonary sarcoidosis

Abstract

Abstract:Aim: Sarcoidosis is a multisystemic disease with typical or atypical pulmonary and extra-pulmonary symptoms or frequently withoutsymptoms. Presence of typical clinical findings and symptoms contribute to rapid diagnosis, whereas asymptomatic progressionleads to delays in the diagnosis. The aim of this study was to investigate the delay in diagnosis in between patients with pulmonaryand/or extra-pulmonary involvement and related symptoms and those without symptoms.Material and Methods: Patients in the sarcoidosis clinics between 2010-2015, were retrospectively evaluated. The cases weregrouped according to the presence or absence of symptoms (pulmonary and/or extra-pulmonary). The groups were compared withregard to the delay in diagnosis.Results: Among the 300 patients, 209 (69%) were female. The mean age was 43±11.68. The disease was stage I in 67.3%, stage IIin 23.7%, stage III in 5.7% and stage 0 in 3.3% of the patients. No significant difference was observed between symptomatic andasymptomatic patients with regard to total duration until diagnosis (p=0.78). A statistically significant difference was observedbetween patients groups with regard to physician-related delayed diagnosis(p=0.026). The mean delay in physician-relateddiagnosis was observed to be longer in asymptomatic cases (21.44 days) compared to patients with pulmonary symptoms (13.66days)(p=0.036). In asymptomatic cases, the mean duration of physician-related delayed diagnosis (21.44 days) was observed to belonger in comparison with patients with extra-pulmonary symptoms (12.79 days)(p=0.016). In patient-related delayed diagnosis, nodifference was observed between groups with regard to the duration until diagnosis(p=0.78).Conclusion: Comparison of delayed diagnosis between patients with or without pulmonary and/or extra-pulmonary symptomsrevealed a longer duration of delay in asymptomatic cases compared to symptomatic cases. The timing of diagnosis is veryimportant in sarcoidosis in order to reduce morbidity and mortality; a suspicious approach to asymptomatic patients will increasethe possibility of diagnosis and prevent delayed diagnosis.