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Diffuse Lung Disease |

The Effect of Deployment on the Severity of Sarcoidosis in Active Duty Military

Joshua Hamilton; Edward McCann; Frederic Rawlins; Michael Morris
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San Antonio Uniformed Services Health Education Consortium, San Antonio, TX


Chest. 2014;146(4_MeetingAbstracts):366A. doi:10.1378/chest.1991223
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Abstract

SESSION TITLE: Interstitial Lung Disease Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Ongoing studies are investigating the potential link between deployment to OIF/OEF and relationship to increases in pulmonary disease. While increases in acute eosinophilic pneumonia cases from theater are well established, data on other chronic pulmonary diseases such as sarcoidosis has not been defined. Concerns have been raised about the ubiquitous presence of ambient particulate matter and localized exposures to burn pits and other agents.

METHODS: A retrospective chart review was conducted of all active duty military personnel diagnosed with sarcoidosis from 2005 to 2010. Deployment dates and locations were obtained through the Armed Forces Health Surveillance Center. Electronic medical records were reviewed to determine the following parameters: dates of diagnosis, temporal relationship of diagnosis and deployment, symptoms (pre and/or post deployment), spirometric parameters, DLCO, radiographic staging as well as treatment medications.

RESULTS: A cohort of 505 Army soldiers was identified with sarcoidosis based on ICD-9 codes and individual review of the medical records. The cohort was 80% male. 38.7% of soldiers with sarcoidosis never deployed. 11.2% were diagnosed prior to deployment, and 50.1% were diagnosed post-deployment. The diagnosis of sarcoidosis was established with a tissue diagnosis in 68% of the deployed cohort. Overall differences in PFTs were not identified. Obstructed PFTs were similar in all deployment groups (never, pre, post) at 9.2%, 15.8% and 8.7% respectively. Restrictive patters were similar at 9%, 3.5%, and 8.3% respectively while reduced DLCO (< 60% pred) was 18%, 8.8%, and 16.3% in the groups. Radiographic staging showed a similar distribution in the populations with the post deployment group having Stage 0 = 24%, Stage I = 34%, Stage II = 32%, Stage III = 8% and Stage IV 1%.

CONCLUSIONS: Based on this analysis of Army sarcoidosis patients, there are similar rates of sarcoid diagnosis in deployed and non-deployed soldiers. Spirometric values, DLCO, and radiographic staging did not show significant differences between groups.

CLINICAL IMPLICATIONS: While unable to determine if sarcoidosis is directly related to deployment, there does not appear to be any increase in radiographic or spirometric severity.

DISCLOSURE: The following authors have nothing to disclose: Joshua Hamilton, Edward McCann, Frederic Rawlins, Michael Morris

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