PURPOSE: The prevalence of sarcoidosis in African-Americans is 150-200 per 100,000 population, approximately 3-4 times the European-American population. Morbidity and mortality due to sarcoidosis is higher in African-Americans. We hypothesize that African-American patients with sarcoidosis have different degrees of pulmonary function limitation than their European-American counterparts.
METHODS: This was a retrospective chart review from 10/1/98 to 9/1/05 of patients with the diagnosis of sarcoidosis listed in their chart. The patients were classified as black or white.
RESULTS: One hundred and eighty six patients were classified as having the diagnosis of sarcoidosis based on their medical records. Of these 186 patients, the diagnosis could be confirmed in 108 upon complete review. Furthermore, some of these 108 were diagnosed at outside facilities and copies of their pathology reports were not available. In our study we included the 69 patients who actually had biopsy proven diagnosis at our V.A medical center. Of these, 49 had pulmonary function tests (PFT's) done at the time of their diagnosis. We reviewed these PFT's, and we also documented the patients' smoking status. There were 33 black and 16 white patients.There was no difference between the smoking status of black patients (61% smoked) versus white patients (63% smoked) using the Fisher's exact test (p=1).PFTs were divided into normal, obstructive, or restrictive (with or without concomitant obstruction). We used the data of the European-American patients with sarcoidosis to establish the expected rates of PFT abnormalities. The respective rates for white patients were 44%, 50%, and 6%. The respective rates for black patients were 24%, 24%, and 51%. These rates are significantly different using the Chi-square test (p< 0.0001) on a contingency table of observed versus expected.
CONCLUSION: Given the same percentage of smokers, black patients with sarcoidosis have different rates of PFT impairment than their white counterparts.
CLINICAL IMPLICATIONS: These results agree with other studies describing the severity of sarcoidosis in the black population. PFTs may aid in the diagnosis, even in smokers. Future studies should address this possibility.
DISCLOSURE: Demondes Haynes, None.