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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