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The impact of demographic disparities in the presentation of sarcoidosis: A multicenter prospective study - 19/10/21

Doi : 10.1016/j.rmed.2021.106564 
Ying Zhou a, , Alicia K. Gerke b, Elyse E. Lower c, Alexander Vizel d, Deepak Talwar e, Irina Strambu f, Joel Francesqui g, Jacobo Sellares g, Michiru Sawahata h, Ogugua Ndili Obi i, Sonoko Nagai j, Kiminobu Tanizawa j, k, Marc A. Judson l, Florence Jeny m, Dominique Valeyre m, Marina Dornfeld Cunha Castro n, Carlos Pereira n, Meyer Balter o, Robert P. Baughman c
a Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, 200433, China 
b Department of Internal Medicine, Pulmonary and Critical Care, University of Iowa, 200 Hawkins Dr, Iowa City, IA, 52246, USA 
c Internal Medicine, University of Cincinnati, University of Cincinnati Medical Center, Cincinnati, OH, 45267-0565, USA 
d Kazan State Medical University, Department of Phthisiopulmonology. Butlerov Str., 49. Kazan, Tatarsan Republic. 420012, Russian Federation 
e Department of Pulmonary and Sleep Care Medicine, Metro Multispeciality Hospital, Noida, Uttar Pradesh, India 
f Pulmonology Department, University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania 
g Servei de Pneumologia, Respiratory Institute, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain 
h Division of Pulmonary Medicine, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, 329-0498, Japan 
i Division of Pulmonary, Critical Care and Sleep Medicine, Brody School of Medicine, East Carolina University, Greenville, NC, USA 
j Kyoto Central Clinic, Clinical Research Center, Kyoto, Japan 
k Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan 
l Department of Medicine, Albany Medical College, Albany, NY, USA 
m Service de Pneumologie, Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Bobigny, France 
n Department of Medicine, Division of Respiratory Diseases, Interstitial Lung Diseases Center, Federal University of São Paulo (UNIFESP), São Paulo, Brazil 
o Division of Respirology, Dept of Medicine, Mount Sinai Hospital, Toronto, ON, Canada 

Corresponding author. 507 Zheng Min Road, Shanghai 200433, China.507 Zheng Min RoadShanghai200433China

Abstract

Objective

To study how demographic differences impact disease manifestation of sarcoidosis using the WASOG tool in a large multicentric study.

Methods

Clinical data regarding 1445 patients with sarcoidosis from 14 clinical sites in 10 countries were prospectively reviewed from Feb 1, 2020 to Sep 30, 2020. Organ involvement was evaluated for the whole group and for subgroups differentiated by sex, race, and age.

Results

The median age of the patients at diagnosis was 46 years old; 60.8% of the patients were female. The most commonly involved organ was lung (96%), followed by skin (24%) and eye (22%). Black patients had more multiple organ involvement than White patients (OR = 3.227, 95% CI: 2.243–4.643) and females had more multiple organ involvement than males (OR = 1.238, 95% CI: 1.083–1.415). Black patients had more frequent involvement of neurologic, skin, eye, extra thoracic lymph node, liver and spleen than White and Asian patients. Women were more likely to have eye (OR = 1.522, 95%CI: 1.259–1.838) or skin involvement (OR = 1.369, 95%CI: 1.152–1.628). Men were more likely to have cardiac involvement (OR = 1.326, 95%CI: 1.096–1.605). A total of 262 (18.1%) patients did not receive systemic treatment for sarcoidosis. Therapy was more common in Black patients than in other races.

Conclusion

The initial presentation and treatment of sarcoidosis was related to sex, race, and age. Black and female individuals are found to have multiple organ involvement more frequently. Age at diagnosis<45, Black patients and multiple organ involvement were independent predictors of treatment.

Le texte complet de cet article est disponible en PDF.

Highlights

It is an international study with large cohort of patients with sarcoidosis.
Organ involvement and treatment differed according to race, sex, and age.
Black and female individuals were more likely to have multiple organ involvement.
Age at diagnosis<45, Black patients and multiple organ involvement were independent predictors of treatment.

Le texte complet de cet article est disponible en PDF.

Keywords : Sarcoidosis, Demographic disparities, Organ involvement, Clinical manifestation


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Vol 187

Article 106564- octobre 2021 Retour au numéro
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