1999 Volume 21 Issue 2 Pages 113-117
A 27-year-old man with a past history of sarcoidosis-associated uveitis presented with a dry cough. He was admitted to our hospital for the evaluation of advanced lung fibrosis and cavitary lesions in the upper lung field on his chest X-ray film. The chest CT on admission showed multiple cavitary lesions with thick walls and nodular opacities in both upper lobes. Bronchoscopy on admission showed vascular network vessels at the carina and granular lesion in the right B5. Pulmonary sarcoidosis was diagnosed by bronchial biopsy. Three regimens of methylprednisolone (1g/day, i.v.) for three days at 7 day interval dramatically improved clinical symptom, lung function, lung fibrotic lesions on the chest X-ray film, and also bronchoscopic granular lesions, although chest CT scan revealed that cavitary lesions with thin walls remained. The steroid pulse therapy was followed by prednisolone (30mg/day, p.o.) and its dose was gradually decreased to 5mg/day. There has been no sign of reccurrence for 14 months since the first therapy.