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Diffuse Lung Disease |

Presence of Ground Glass Opacities on Chest Imaging Varies by Race and Correlates With Decreased Lung Function in Patients With Sarcoidosis

Kristyn Sayball, DO; Thomas Iden, MD; Aamer Syed, MD; Lester Farner, MD; Robert Groves; Walter James, MD
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Virginia Commonwealth University Medical Center, Richmond, VA


Chest. 2015;148(4_MeetingAbstracts):398A. doi:10.1378/chest.2277432
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Abstract

SESSION TITLE: Diffuse Lung Disease Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: African Americans with sarcoidosis in the United States have been shown to have greater disease severity and poorer outcomes when compared to Caucasians with sarcoidosis. The presence of ground glass opacities (GGO) on computed tomography of the chest (CT) has been associated with progression to fibrosis and decline in pulmonary function testing (PFT). The aim of our study is to investigate racial differences in the presence of GGO on CT in patients with sarcoidosis and if this correlates with reduced lung function.

METHODS: Retrospective cohort study of patients at a tertiary care center in the Southeastern United States with biopsy-proven sarcoidosis with CT chest and PFTs within 6 months from the time of biopsy. Patient age, race, and gender were noted. Scadding stages and presence of GGO were determined independently by two board certified thoracic radiologists. Multivariate analyses using general linear equation were performed to compare the incidence of GGO between Caucasian and African American patients as well as correlation with percent predicted for forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and diffusing capacity of the lung for carbon monoxide (DLCO). Alpha was set at 5%.

RESULTS: A total of 97 patients were included in the analysis; 80.4% were African American and 60.8% were female. Thirty-three percent (26 out of 78) of African Americans had GGO on chest CT, while only 5.3% (1 out of 19) of Caucasians had GGO on imaging (p=0.01). The presence of GGO, regardless of race, was associated with a significant reduction in FVC percent (73.7% vs 87.1%, p 0.02), FEV1 (72.5% vs 83.4%, p 0.03), and DLCO (62% vs 75.6%, p < 0.01).

CONCLUSIONS: Our study demonstrates a significantly higher incidence of GGO in African American patients with sarcoidosis when compared to Caucasians. The presence of GGO on CT was associated with reduced FVC, FEV1, and DLCO. This is the first study to our knowledge that describes differences in the presence of GGO on CT imaging between races.

CLINICAL IMPLICATIONS: The presence of GGO on chest CT has been associated with progression of disease. The higher incidence of GGO in African American patients with sarcoidosis and the association of this finding with a reduction in lung function suggest African Americans may be at increased risk for progression of disease compared to Caucasians. Detecting the presence of GGO on chest CT may aid clinicians in risk stratifying sarcoidosis patients.

DISCLOSURE: The following authors have nothing to disclose: Kristyn Sayball, Thomas Iden, Aamer Syed, Lester Farner, Robert Groves, Walter James

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