PURPOSE: Epidemiological literature shows Sarcoidosis among Chinese is a rare diagnosis, possibly attributable to low disease awareness in Asia.We reviewed case histories for patients of Chinese origin within our hospital over the past eleven years. Based in Flushing, New York, USA, our community-based hospital serves a broad multi-ethnic population; the U.S. Census Bureau reports a 56% Asian population, predominantly Chinese immigrants.
METHODS: We obtained data from our medical record database covering the past 11.5 years using CPT diagnosis codes for Sarcoidosis (135)–395 cases, lung granuloma (515) and mediastinal granuloma (519.3)—347 cases, and mediastinoscopies (342.2)—200 cases.Database analysis identified seven patients of known Chinese origin with pre-existing or newly-diagnosed Sarcoidosis.
RESULTS: By 1981, only 11 Sarcoidosis cases among people of Chinese origin had been reported. A 1997 article reports 38 incidences over five years among the local Chinese population in Taiwan, with disease-specific rates of 0.027 out of 100,000. A 1992 epidemiology review reported a history of 64 cases in 17 surveyed hospitals in China. By comparison, Japan and Korea have reported incidence rates of 1.3/100,000 and 0.125/100,000, respectively.Similar to those described in earlier case reports, particularly among the Chinese from Taiwan, our diagnosed patient population had higher prevalence among females, high frequency of intra-thoracic involvement, and low incidence of hypercalcemia and hyperglobulinemia. Our patients mainly presented with abnormal chest X-rays and mediastinal lyphadenopathy. Our cohort had mild pulmonary symptoms. Extra-thoracic manifestations were not seen, except for eye involvement in one patient and renal insufficiency in another.
CONCLUSION: We have identified seven confirmed cases of Sarcoidosis among Chinese-origin individuals, suggesting that the disease may be more prevalent among this population than previously thought. Low disease awareness in Asia is a possible cause for this discrepancy.
CLINICAL IMPLICATIONS: Although Sarcoidosis is usually associated with African-Americans in U.S., it should be a differential diagnosis of Chinese-Americans presenting with mediastinal lymphadenopathy.
DISCLOSURE: Sukriti Singhal, No Financial Disclosure Information; No Product/Research Disclosure Information