Morphological Changes in Nasal Mucosa in Patients with Sarcoidosis.
Objectives: The purpose of this study was the evaluation of any
alterations in the microvascular network of the nasal mucosa in patients
with pulmonary sarcoidosis and the investigation of potential
correlations with olfactory acuity and serum levels of
angiotensin-converting enzyme (sACE). Design: Patients’ nasal mucosa was
examined with contact endoscopy (CE). A novel classification scheme for
the microvascular pattern at the anterior septal mucosa (Little’s area)
was introduced and implemented. Olfaction was tested using
sniffin’sticks. Fifteen healthy subjects served as controls.
Participants: 15 patients with pulmonary sarcoidosis and sinonasal
symptoms. Main outcome measures: Microvascular pattern at the anterior
septal mucosa (Little’s area). Olfaction tested using sniffin’sticks.
Setting: Tertiary referral medical centre. Results: The nasal
microvascular network was disrupted under CE in most (14/15) patients,
while in one patient no microvascular net could be detected. Moreover,
hyposmia was documented in four patients and complete anosmia in one
patient. In healthy subjects, a very strong correlation between vascular
pattern of the mucosa and olfactory test results was found (r=0.93).
Conclusions: Contact endoscopy findings show promise and should be
further tested, to evaluate their validity as a surrogate marker of
mucosal nasal inflammation in sarcoidosis patients with sinonasal
symptoms. Vascular patterns of nasal mucosa and olfaction seem to be