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Clinical Investigations: SARCOIDOSIS |

Sarcoidosis Diagnosed in Elderly Subjects*: Retrospective Study of 30 Cases

Pascal Chevalet, MD; Renaud Clément, MD; Olivier Rodat, MD; Anne Moreau, MD; Jean-Marie Brisseau, MD; Jean-Patrick Clarke, MD
Author and Funding Information

*From the Federation of Geriatric Medecine, Department of Geriatric Medecine (Drs. Chevalet and Brisseau), Hôpital Léon Bellier; and Departments of Geriatric Medecine (Drs. Clément and Rodat), Pathology (Dr. Moreau), and Pulmonary Diseases (Dr. Clarke), Nantes University Hospital, Nantes, France.

Correspondence to: Pascal Chevalet, MD,Department of Geriatric Medecine, Hôpital Léon Bellier, 41 rue Curie, BP 84607, 44046 Nantes Cedex 1, France; e-mail: pascal.chevalet@chu-nantes.fr



Chest. 2004;126(5):1423-1430. doi:10.1378/chest.126.5.1423
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Study objective: This study investigated the clinical features and disease course of sarcoidosis diagnosed in patients > 70 years of age.

Methods: A retrospective analysis was made of cases treated at the University Hospital in Nantes, France, between 1986 and 2000. The diagnosis of sarcoidosis was confirmed histopathologically. Cases involving progressive cancer and active tuberculosis were excluded.

Results: Thirty white patients with sarcoidosis diagnosed after age 70 years (mean, 74 years) were included. An alteration of general health (asthenia and/or anorexia and/or weight loss) was frequent (53%) and characteristic of the systemic form of the disease. Dyspnea was a fairly common sign (23%). The intrathoracic form of sarcoidosis was most frequent (43.3%). Diagnosis was difficult and lengthy, and symptomatology was atypical. Accessory salivary gland biopsy was an important contributing factor to diagnosis (70.6% were positive). Oral corticosteroid therapy was often required (60.7%). The disease course was satisfactory overall (81.8% of cases), but only for 50% of patients in intrathoracic stage IV.

Conclusions: The clinical presentation of sarcoidosis in elderly subjects is mainly characterized by an alteration of general health. Diagnosis is difficult and should include accessory salivary gland biopsy. Therapy frequently involves corticosteroids. Overall prognosis is similar to that for young subjects.


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