Gibson et al listed criteria for when to start corticosteroid therapy in a patient with pulmonary sarcoidosis. The authors are from the Sarcoidosis Subcommittee of the Research Committee of the British Thoracic Society.
Patient selection: pulmonary sarcoidosis
Parameters affecting the decision to start therapy:
(1) disability
(2) pulmonary function tests
Diability – all of the following:
(1) The symptoms are distressing to the patient – cough, breathlessness, etc.
(2) The symptoms are interfering with the patient’s activities of daily living (ADL).
(3) The physician feels the need to initiate therapy.
Pulmonary Function Test
Treat if
vital capacity
< 75% of best recorded value
vital capacity
< 50% of predicted
diffusing capacity of carbon monoxide
< 60% of best recorded value
Corticosteroid therapy was 30 mg prednisolone per day for 30 days followed by gradual tapering off over 6 to 9 months, subject adjustments for the patient’s response.
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