Prognosis

Patients with sarcoidosis generally have a good prognosis (1).

Some information concerning the prognosis in sarcoidosis is given below:

• spontaneous remission is seen in
  • 55–90% of patients with stage I radiological disease
  • 40–70% with stage II disease
  • 10–20% with stage III disease
  • 0% in stage IV disease (2).
• In majority of patients remission occurs within the first 6 months (2)
• the disease wax and wane (can be spontaneous or after treatment)
• adverse prognosis is seen in patients with
  • those aged 40 or more at onset
  • black patients
  • lupus pernio
  • chronic uveitis
  • chronic hepercalcaemia
  • nephrocalcinosis
  • progressive pulmonary sarcoidosis
  • cystic bone lesions
  • neurosarcoidosis
  • myocardial involvement (1,2)
• HLA-B13 and HLA-D27 appear to be markers of more chronic disease
• overall mortality in sarcoidosis is estimated to be around 1–5% , majority are due to pulmonary, myocardial or CNS involvement (3)
• as many as 10% will become disabled by pulmonary fibrosis

Reference:

• (1) Dempsey OJ et al. Sarcoidosis. BMJ. 2009 Aug 28;339:b3206
• (2) Wu JJ, Schiff KR. Sarcoidosis. Am Fam Physician. 2004;70(2):312-22.
• (3) Bradley B et al.Interstitial lung disease guideline: the British Thoracic Society in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society. Thorax. 2008;63 Suppl 5:v1-58.