Immanuel Subash, G (2015) Assessment of Fatigue and Other Extra-Pulmonary Manifestations in Patients Diagnosed with Sarcoidosis: A Prospective Observational study in a South Indian Tertiary Care Centre. Masters thesis, Christian Medical College, Vellore.
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Abstract
OBJECTIVES: PRIMARY OBJECTIVE: To assess the prevalence of fatigue with the help of FAS (Fatigue assessment scale) in all patents with Histo-pathologically proven sarcoidosis, both old and new, treatment naïve and on treatment, in the department of Pulmonary Medicine. SECONDARY OBJECTIVE: Secondary objective of the study was to observe and present the prevalence of other extra-pulmonary manifestations in the same cohort. METHODS: We included all patients in our department with the diagnosis of Sarcoidosis, which was proven histo-pathologically. Both newly diagnosed and patients who were on treatment were included. They were asked to fill in a Quality of life questionnaire – FAS (Fatigue assessment scale), which has been validated for use in patients with sarcoidosis to assess fatigue. A score of more than 21 was considered to be significant for fatigue. For assessing other extra-pulmonary manifestations basic screening tests which were done as part of routine work up was used, Ophthalmological and Dermatological screening was done for all of them. RESULTS: We included 75 patients in our study. We found fatigue as a symptom with the help of FAS more than 21 in 73.3% of patients. In newly diagnosed patients prevalence was 85.7% compared to old patients in who it was 66%. Patients on steroids had 9% higher risk of having fatigue, but statistically it was not found to be significant (odd’s ratio; 0.98, p value; 0.752). There was no significant difference statistically in age or female sex – odd’s ratio of 0.99 and 1.09 respectively. Assessing other extra-pulmonary manifestations we found highest prevalence in Eye and Skin with 26% and 20% respectively. Other organs involved in decreasing order of prevalence were Liver (13%), Bone/Joint/Muscle (10.6%), Spleen (9.3%), Calcium/Kidney (6.6%), Brain (4%), ENT (4%), Heart (1.3%), and Parotid gland (1.3%). CONCLUSION: We studied patients with sarcoidosis which is a rare disorder. We included 75 patients in our study and assessed the prevalence of fatigue and other extra-pulmonary manifestations. Prevalence of sarcoidosis is very high, we found the prevalence to be 73.3%, which is in accordance with the studies mentioned in the review of literature. It may be as high as 87.5% in newly diagnosed patients. Since we had patients who were on follow up and patients who were treatment naïve, we assessed the difference between both the groups. In follow up patients prevalence was 66% compared to 87% in the newly diagnosed group). There was no significant difference statistically in age or female sex – odd’s ratio of 0.99 and 1.09 respectively in the study, which could be because of the small sample size. A larger study is required to analyse risk factors like age and sex on fatigue in sarcoidosis. Mainstay of treatment for sarcoidosis is steroids. Steroids may induce myopathy and cause fatigue. We found patients on steroids had 9% higher risk of having fatigue, but statistically it was not found to be significant (odd’s ratio; 0.98, p value; 0.752). Our study reiterates the importance of fatigue as a predominant symptom in patients with sarcoidosis which may be ignored in the clinical setting. Further studies are required to identify therapies which may help patients in treating this symptom. Treatment of fatigue will improve quality of life of the patient which is one of the primary goals of treating patients with sarcoidosis.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Fatigue ; Extra-Pulmonary Manifestations ; Sarcoidosis ; Prospective Observational study ; South Indian ; Tertiary Care Centre. |
| Subjects: | MEDICAL > Tuberculosis and Respiratory Medicine |
| Depositing User: | Punitha K |
| Date Deposited: | 06 May 2018 04:25 |
| Last Modified: | 06 May 2018 04:25 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/7526 |
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