Clinical Characteristics of Sarcoidosis in Asian Population: A 14-year Single Center Retrospective Cohort Study from Thailand

Main Article Content

Athiwat Tripipitsiriwat
Chulaluk Komoltri
Ruchira Ruangchira-urai
Patompong Ungprasert

Keywords

Sarcoidosis, epidemiology, uveitis, Non-caseating granuloma, Asian

Abstract

Background: Little is known about epidemiology and clinical characteristics of sarcoidosis in Asian population.


Objectives: This study aimed to examine the epidemiology and clinical characteristics of Thai patients with sarcoidosis, using databases of a tertiary care medical center.


Methods: Potential cases of sarcoidosis were identified from two sources, the medical record-linkage system and the pathology database of Siriraj Hospital, Mahidol University in Bangkok, Thailand. Patients with ICD-10-CM codes for sarcoidosis were identified and retrieved from the medical record-linkage system from 2005 to 2018. Patients with histopathology positive for non-caseating granuloma were identified and retrieved from the pathology database from the same time period. All potential cases underwent individual medical record review to confirm the diagnosis of sarcoidosis which required compatible clinical pictures supported by presence of non-caseating granuloma, radiographic evidence of intrathoracic sarcoidosis and exclusion of other granulomatous diseases.


Results: From 2005 to 2018, 89 confirmed cases of sarcoidosis were identified. 80.9% of them were female and mean age at diagnosis was 46.8 years (standard deviation (SD) 13.9 years). The majority of patients had intrathoracic disease (81 cases; 91.0%) but less than half had respiratory symptoms (34 cases; 41.9%). Extrathoracic disease was common in this cohort that pulmonary sarcoidosis was accompanied by extrathoracic involvement in 53 patients (65.4%). Sarcoid uveitis was the most common extrathoracic disease (35 cases; 39.3%), followed by cutaneous sarcoidosis (24 cases; 26.9%), extrathoracic lymphadenopathy (18 cases; 22.5%) and sarcoid arthropathy (4 cases; 4.5%).


Conclusion: The current study examined clinical characteristics of sarcoidosis in an Asian population and found high prevalence of uveitis and marked female predominance.

Abstract 725 | PDF Downloads 285

References

1. Chen ES, Moller DR. Etiology of sarcoidosis. Clin Chest Med. 2008;29:365-77.
2. Webber MP, Yip J, Zeig-Owens R, Moir W, Ungprasert P, Crowson CS, et al. Post-9/11 sarcoidosis in WTC-exposed firefighters and emergency medical service workers. Respir Med. 2017;132:232-7.
3. Newman LS, Rose CS, Bresnitz EA, Rossman MD, Barnard J, Frederick M, et al. A case control etiologic study of sarcoidosis: environmental and occupational risk factors. Am J Respir Crit Care Med. 2004;170:1324-30.
4. Judson MA, Boan AF, Lackland DT. The clinical course of sarcoidosis: presentation, diagnosis, and treatment in a large white and black cohort in the United States. Sarcoidosis Vasc Diffuse Lung Dis. 2012;29:119-27.
5. Ungprasert P, Carmona EM, Utz JP, Ryu JH, Crowson CS, Matteson EL. Epidemiology of sarcoidosis 1946-2013: A population-based study. Mayo Clin Proc. 2016;91:183-8.
6. Cozier YC, Berman JS, Palmer JR, Boggs DA, Serlin DM, Rosenberg L, Sarcoidosis in black women in the United States: Data from the black women’s health study. Chest. 2011;139:144-50.
7. Park JE, Kim YS, Kang MJ, Kim CJ, Han CH, Lee SM, et al. Prevalence, incidence and mortality of sarcoidosis in Korea, 2003-2015: A nationwide population-based study. Respir Med. 2018;144S:S28-S34.
8. Morimoto T, Azuma A, Abe S, Usuki J, Kudoh S, Sugisaki K, et al. Epidemiology of sarcoidosis in Japan. Eur Respir J. 2008;31:372-9.
9. Baughman RP, Field S, Costabel U, Crystal RG, Culver DA, Drent M, et al. Sarcoidosis in America. Analysis based on health care use. Ann Am Thorac Soc. 2016;13:1244-52.
10. Ungprasert P, Ryu JH, Matteson EL. Clinical manifestations, diagnosis and treatment of sarcoidosis. Mayo Clin Proc Inn Qual Out. 2019;3:358-75.
11. Mirsaedi M, Machado RF, Schraufnagel D, Sweiss NJ, Baughman RP. Racial difference in sarcoidosis mortality in the United States. Chest. 2015;147:438-49.
12. Baughman RP, Tierstein AS, Judson MA. Clinical characteristics of patients in case control study of sarcoidosis. Am J Respir Crit Care Med. 2001;164(10 Pt 1):1885-9.
13. Yoon HY, Kim HM, Kim YJ, Song JW. Prevalence and incidence of sarcoidosis in Korea: a nationwide population-based study. Respir Res. 2018;19:518
14. Park JE, Kim YS, Kang MJ, Kim CJ, Han CH, Lee SM, et al. Prevalence, incidence and mortality of sarcoidosis in Korea, 2003-2015: a nationwide population-based study. Respir Med. 2018;144S:S28-S34
15. Costabel U, Hunninghake GW (1999) ATS/ERS/WASOG statement on sarcoidosis. Sarcoidosis Statement Committee. American Thoracic Society. European Respiratory Society. World Association for Sarcoidosis and Other Granulomatous Disorders. Eur Respir J. 1999;14:735-7.
16. Zajicek JP, Scolding NJ, Foster O, Rovaris M, Evanson J, Moseley IF, et al. Central nervous system sarcoidosis – diagnosis and management. QJM. 1999;92:103-17.
17. Birnie DH, Sauer WH, Bogun F, Cooper JM, Culver DM, Duvernoy CS, et al. HRS expert consensus statement on the diagnosis and management of arrhythmias associated with cardiac sarcoidosis. Heart Rhythm. 2014;11:1305-23.
18. Herbort CP, Rao NA, Mochizuki M; members of Scientific Committee of First International Workshop on Ocular Sarcoidosis. International criteria for the diagnosis of ocular sarcoidosis: results of the first International Workshop on Ocular Sarcoidosis (IWOS). Ocul Immunol Inflamm. 2009;17:160-9.
19. Birnbaum AD, French DD, Mirsaeidi M, Wehrli S. Sarcoidosis in the national veteran population: association of ocular inflammation and mortality. Ophthalmology. 2015;122:934-8.
20. Coquart N, Cadelis G, Tressieres B, Cordel N. Epidemiology of sarcoidosis in Afro-Caribbean people: a 7-year retrospective in Guadeloupe. Int J Dermatol. 2015;54:188-92.
21. de Boer S, Milne DG, Zeng I, Wilsher ML. Does CT scanning predict the likelihood of a positive transbronchial biopsy in sarcoidosis? Thorax. 2009;64:436-9.
22. Shorr AF, Torrington KG, Hnatiuk OW. Endobronchial biopsy for sarcoidosis: a prospective study. Chest. 2001;120:109-14.
23. Polychronopoulos VS, Prakash UBS. Airway involvement in sarcoidosis. Chest. 2009;136:1371-80.
24. Ungprasert P, Wetter DA, Crowson CS, Matteson EL. Epidemiology of cutaneous sarcoidosis, 1976-2013: a population-based study from Olmsted County, Minnesota. J Eur Acad Dermatol Venereol. 2016;30:1799-804.
25. Pietinalho A, Ohmichi M, Lofroos AB, Hiraga Y, Selroos O. The prognosis of pulmonary sarcoidosis in Finland and Hokkaido, Japan. A comparative five-year of biopsy-proven cases. Sarcoidosis Vasc Diffuse Lung Dis. 2000;17:158-66.
26. Hunninghake GW, Gilbert S, Pueringer R, Dayton C, Floerchinger C, Helmers R, et al. Outcome of the treatment of sarcoidosis. Am J Resp Crit Care Med. 1994;149(4 pt 1):893-8.
27. Ungprasert P, Tooley AA, Crowson CS, Matteson EL, Smith WM. Clinical characteristics of ocular sarcoidosis: A population-based study 1976-2013. Ocular Immunol Inflamm. 2019;27:389-95.
28. Ungprasert P, Matteson, Crowson CS. Accuracy of Diagnostic Coding for Sarcoidosis in Electronic Databases: A Population-Based Study. Lung. 2017;195:713-5.