Inhaled corticosteroid rapidly improved pulmonary sarcoidosis.

We report two cases in whom inhaled corticosteroid rapidly improved pulmonary sarcoidosis. In the first case, fluticasone at 400 microg/day was initiated, because dry cough and small nodular shadows on chest X-ray persisted for six months. But her cough and the nodular shadows were persisted, therefore the treatment was replaced with budesonide at 800 microg/day. Two months later, her dry cough subsided and pulmonary shadows improved. Serum angiotensin-converting enzyme (ACE) level was decreased and pulmonary function improved. In the second case, bumethasone was already administered at a local clinic. Budesonide at 400 microg/day was combined with oral steroid, because pulmonary shadows continued for eight years. Also two months later, the serum ACE level was decreased and the pulmonary shadows slightly improved. Inhaled corticosteroid therapy for two to three months is tolerable, and may be a useful treatment option in some patients with sarcoidosis.