http://repub.eur.nl/res/aut/24183/ List of Publications en http://repub.eur.nl/static-eur/img/logo.png http://repub.eur.nl http://repub.eur.nl/res/pub/20206/ 2010-12-01T00:00:00Z Small fibre neuropathy (SFN) has been demonstrated in sarcoidosis. However, a systematic analysis of neuropathic pain and autonomic symptoms, key features of SFN, has not been performed. Clinimetric evaluation of pain and autonomic symptoms using the neuropathic pain scale (NPS) and the modified Composite Autonomic Symptoms Scale (mCOMPASS) was used in sarcoidosis patients for this study. A total of 91 sarcoidosis patients (n = 23 without SFN symptoms, n = 43 with SFN symptoms but normal intraepidermal nerve fibre density (IENFD), n = 25 with SFN symptoms and reduced IENFD) were examined. NPS and mCOMPASS were assessed twice (reliability studies). Severity of pain was compared between the subgroups. Correlation between NPS and a visual analogue pain scale (VAS) was assessed (validity studies). Healthy controls (n = 105) completed the mCOMPASS for comparison with patients' scores. Patients with sarcoidosis, SFN complaints, and reduced IENFD demonstrated more severe pain scores on the NPS. The mCOMPASS differentiated between subjects with and without SFN symptoms. A significant correlation was obtained between the NPS and VAS, indicating good construct validity. Good reliability values were obtained for all scales. The use of the NPS to evaluate SFN symptoms is suggested, as it shows differences between patients with SFN symptoms with normal or reduced IENFD values. The mCOMPASS might be used to select patients for further testing. http://repub.eur.nl/res/pub/29903/ 2008-06-01T00:00:00Z The aim of the present study was to investigate the efficacy of infliximab for the treatment of extrapulmonary sarcoidosis. A prospective, randomised, double-blind, placebo-controlled trial was conducted, with infliximab at 3 and 5 mg·kg-1body weight administered over 24 weeks. Extrapulmonary organ severity was determined by a novel severity tool (extrapulmonary physician organ severity tool; ePOST) with an adjustment for the number of organs involved (ePOSTadj). In total, 138 patients enrolled in the trial of infliximab versus placebo for the treatment of chronic corticosteroid-dependent pulmonary sarcoidosis. The baseline severity of extrapulmonary organ involvement, as measured by ePOST, was similar across treatment groups. After 24 weeks of drug-therapy study, the change from baseline to week 24 in ePOST was greater for the combined infliximab group compared with the placebo group. After adjustment for the number of extrapulmonary organs involved, the improvement in ePOSTadj observed in the combined infliximab group was also greater than that observed in placebo-treated patients, after 24 weeks of therapy. The improvements in ePOST and ePOSTadj were not maintained during a subsequent 24-week washout period. Infliximab may be beneficial compared with placebo in the treatment of extrapulmonary sarcoidosis in patients already receiving corticosteroids, as assessed by the severity tool described in the present study. Copyright http://repub.eur.nl/res/pub/37806/ 1993-12-08T00:00:00Z Bronchoalveolar lavage (BAL) is currently widely applied to sample cells and proteins present in the bronchoalveolar space for subsequent studies. Moreover, this limited invasive technique is a sensitive indicator of infectious and non-infectious inflammatory disorders, such as interstitial lung diseases. The aim of this study was to investigate the clinical applications of BAL, in particular the diagnostic value of this method with a view to preventing more invasive procedures. The studies presented in this thesis are based on BAL fluid data obtained from patients during a ten-year period between 1980 and 1990. Cells and proteins, ie, albumin and immunoglobulins, determined in those BAL fluid samples, have been analyzed. Retrospectively, we searched for specific features in the data from the BAL fluid analyses, which distinguish between various interstitial lung diseases. This thesis describes the diagnostic value of BAL fluid sample analyses in patients suffering from various interstitial lung diseases. Emphasis is put on patients with sarcoidosis, extrinsic allergic alveolitis (EAA), or idiopathic pulmonary fibrosis.