Sarcoidosis Clinical Trial
Official title:
Endosonography (EUS and EBUS) vs Conventional Bronchoscopy for the Diagnosis of Sarcoidosis: a Randomized Trial
This randomized study investigates two different diagnostic strategies for patients with
suspected pulmonary sarcoidosis stage I/II.
The objective is to assess the role of endosonography (EBUS/ EUS - FNA) in demonstrating
non-caseating granulomas in comparison with conventional bronchoscopy (TBLB + EBB).
Also the researchers investigate the additional value of BAL, in relation to endosonography
and conventional bronchoscopy (TBLB + EBB), in diagnosing sarcoidosis.
Thirdly the researchers aim to assess the rate of complications in both the endosonography
and conventional bronchoscopic workup.
Sarcoidosis is the most prevalent interstitial lung disease in Western-Europe and the US.
The disease is most prevalent in young adults. To set the final diagnosis of sarcoidosis,
the following parameters need to be present:
1. A clinical and radiological suspicion of sarcoidosis stage I/II.
2. A tissue diagnosis of disease-specific non-caseating granulomas.
3. Exclusion of possible alternative diagnoses as lung cancer or tuberculosis.
Nowadays, a bronchoscopy with lung biopsies is advised to set a tissue diagnosis of
sarcoidosis. However, these biopsies are only diagnostic in 70% of the procedures and they
are associated with a 3% risk of coughing up blood and a 4% risk of a lung collapse.
Since recently, a new diagnostic procedure has come available. This procedure,
endo-sonography, makes it possible to biopsy lymph nodes in the chest under direct
visualization and has a diagnostic accuracy of 85%. The associated risk of complications
appears to be small (<1%)
We consider the current standard for the diagnostics of sarcoidosis to be outdated,
considering the clinical availability of endo-sonography. We expect that endo-sonography is
more frequent diagnostic for a tissue diagnosis of sarcoidosis.
Also we hypothesize that this technique is safer and more preferred by patients.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Diagnostic
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