SESSION TITLE: Race and Ethnicity in Lung Disease
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Monday, October 26, 2015 at 04:30 PM - 05:30 PM
PURPOSE: Sarcoidosis is a multisystem disease most commonly affecting the lungs. Among patients with Scadding stage I disease, most will have spontaneous regression; however, it is difficult to identify those at risk for disease progression. Computed tomography (CT) of the chest allows better characterization of parenchymal involvement in sarcoidosis and may more accurately predict the risk of progression. We sought to determine the prevalence of parenchymal involvement on CT imaging in an American population with stage I sarcoidosis and compare this to the prevalence previously reported in sarcoidosis populations outside the United States.
METHODS: This is a retrospective cohort study of 64 patients from a tertiary care center in the United States with biopsy proven sarcoidosis. Two thoracic radiologists independently reviewed chest radiographs and CTs obtained near the time of biopsy to characterize parenchymal involvement. Descriptive statistics were used to characterize the population and determine the prevalence of parenchymal involvement on CT in patients with stage I sarcoidosis.
RESULTS: In our cohort of 64 patients, 88% were African-American and 64% were female. Nineteen (30%) patients were classified as stage I (14 African-American, 4 Caucasian, and 1 other), and 18 out of 19 (95%) patients with stage I sarcoidosis were shown to have parenchymal involvement on chest CT. The predominant parenchymal disease patterns included 13 patients (68%) with nodules, 8 patients (42%) with mosaic attenuation, and 4 patients (21%) with ground glass; 42% had multiple parenchymal patterns present.
CONCLUSIONS: Similar to previous studies, we show that the Scadding staging system underestimates the number of patients who have parenchymal involvement. In our predominantly African-American population, 95% of patients with stage I sarcoidosis had parenchymal involvement on chest CT, which is greater than previous studies outside the United States that reported a rate of 55%.
CLINICAL IMPLICATIONS: Our study suggests that Americans with stage I sarcoidosis have a greater prevalence of parenchymal disease than previously appreciated. Further studies are needed to determine if the presence of parenchymal disease on CT in stage I sarcoidosis correlates with an increased risk for disease progression.
DISCLOSURE: The following authors have nothing to disclose: Derick Jenkins, Anand Pariyadath, Thomas Iden, Aamer Syed, Walter James
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