Esordio polmonare ed extrapplmonare della sarcoidosi: Confronto tra una casistica prospettica e quella del registro RIPID

Background and aim: RIPID (Registro Italiano Pneumopatie Interstiziali Diffuse) is a register started May 98 to pull together a number of data (age, gender, race, diagnosis, diagnostic criteria, symptoms at presentation and other data) of patients with interstitial lung diseases. Aim of this work is to compare the data of two italian series of sarcoid patients, one recently published from an Internal Medicine Division (Rizzato et al 2004), the other one from the RIPID Pneumological Centers. Results: The major differences regard the percentage of extrapulmonary presentation (Rizzato 36%, RIPID 8%), the percentage of Lofgren syndrome (Rizzato 21%, RIPID 10%), the presentation with respiratory symptoms (Rizzato 13%, RIPID 60%), the prentation with Chest X ray by chance (Rizzato 25%, RIPID 14%), the percentage of histologically proven cases (Rizzato 80%, RIPID 60%), the pulmonary (versus non pulmonary) histological approach to diagnosis (Rizzato 42%, RIPID 91%). Most of the above differences may be explained on the basis of 3 factors: a) the Rizzato report has been perspective, while the RIPID is simply a register; b) the case mix of patients visiting the Pneumological Centres is more lung-oriented in respect to patients visiting an Internal Medicine Division; c) probably the pneumologists are more likely to use transbronchial biopsy, while the internists are more likely to use extra-pulmonary biopsies. Conclusion: In the Pneumological Centres the clinical approach to the patient is different in respect to what happens in an Internal Medicine Division, perhaps due to a different case mix of the patients.