Delayed cutaneous hypersensitivity tests and lymphopenia as activity markers in sarcoidosis

Chest. 2002 Apr;121(4):1239-44. doi: 10.1378/chest.121.4.1239.


Study objectives: To evaluate new and already known biological markers of activity in patients with sarcoidosis.

Design: A 10-year prospective clinical evaluation, including a battery of delayed cutaneous hypersensitivity tests (DCHTs) and other markers of activity.

Setting: Outpatient department of a university teaching hospital.

Patients: Forty patients with biopsy-proven sarcoidosis were prospectively evaluated every 6 months. In this study, only the visits that fulfilled the situation of active period (AcP) or of asymptomatic period (AsP) were taken into account. Twenty-one visits were considered to be in the AcP, and 26 were considered to be in the AsP. Seven patients were studied both in the AcP and the AsP.

Interventions: DCHTs and blood sample extraction every 6 months.

Measurements and results: The mean diameter of the cutaneous wheal for each antigen (AG) was lower in the AcP group than in the AsP group (candidine, p < 0.0001; tuberculin, p < 0.0009; trichophytin, p < 0.02; streptokinase-streptodornase, p < 0.001). Also, the mean (+/- SD) diameter for the four AGs taken together was lower in the AcP group (2.3 +/- 4.2 mm) than in the AsP group (16.8 +/- 9.3 mm; p < 0.0001). The mean serum angiotensin-converting enzyme (S-ACE) value was higher in the AcP group than in the AsP group (p < 0.02). A low lymphocyte count and a percentage of the lymphocyte count (< 20%) also were detected more frequently in the AcP group than in the AsP group (p < 0.02 and p < 0.0001, respectively).

Conclusions: DCHTs appear to be a simple, reliable, and easily performed marker of inflammatory activity in sarcoidosis patients. Furthermore, serum total and differential lymphocyte count and the S-ACE level proved to be useful inflammatory markers in this study.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Forced Expiratory Volume / physiology
  • Humans
  • Hypersensitivity, Delayed / diagnosis*
  • Hypersensitivity, Delayed / immunology
  • Intradermal Tests*
  • Lymphopenia / diagnosis*
  • Lymphopenia / immunology
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Sarcoidosis, Pulmonary / diagnosis*
  • Sarcoidosis, Pulmonary / immunology
  • Skin / immunology
  • Vital Capacity / physiology