Diffuse Lung Disease: Diffuse Lung Disease: Sarcoidosis |

Clinical Characteristics of Patients With Sarcoidosis Using the New Wasog Criteria FREE TO VIEW

Ying Zhou; Robert Baughman, MD; Huiping Li; Elyse Lower
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University of Cincinnati, Cincinnati, OH

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A220. doi:10.1016/j.chest.2016.02.227
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SESSION TITLE: Diffuse Lung Disease: Sarcoidosis

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: A sarcoidosis specific instrument was developed in 1999 to standardize organ involvement and was able to detect differences in rate of organ involvement for newly diagnosed sarcoidosis patients in American based on race, sex, and age (Baughman et al. Am J Respir Crit Care Med 2001; 164:1885-1889). Recently, this organ involvement instrument was updated by the World Association of Sarcoidosis and Other Granulomatous disease (WASOG) (Judson et al. Sarcoidosis Vasc Diffuse Lung Dis 2014; 31:19-27). This new instrument was felt to be more precise in defining disease and includes newer diagnostic criteria, such as positive emission tomography and magnetic resonant imaging.

METHODS: 231 patients with sarcoidosis were enrolled at a single institution. Organ involvement was determined in each patient using the WASOG SAS. Individual organ involvement was felt to be present if there was biopsy confirmation or either “highly probable” or “at least probable” organ involvement. The fourteen distinct areas of organ involvement were compared between race, gender and age (<40 year old and ≥40 year old) groups: lung, neurologic, non-thoracic lymph node, renal, cardiac, skin, eye, liver, bone marrow, spleen, bone/joint, ENT, parotid/salivary and calcium metabolism. The difference of organ involvement were analyzed by c2 test corrected by continuity if needed.

RESULTS: The study population was heterogeneous in terms of race (53.2% white, 46.8% black), gender (71.4% females, 28.6% males), and age (39%<40 year old, 61%≥40 year old). Patients had been diagnosed with sarcoidosis a median of 10 years. Overall, more organ involvement was detected than that reported in the original report. Lung was the most common involved organ (88.3%) with eye (32%) and skin (29%) frequently involved. White patients were more likely to be hypercalcemic (c2=12.776, P=0.000). Men were more likely to have bone marrow involvement (c2=4.298, P=0.038). Subjects with age<40 year old were more likely to have liver involvement, while who with age≥40 year old were more likely to be hypercalcemic (c2=6.830, P=0.009).

CONCLUSIONS: The higher rate of organ involvement reported in this study compared to original reports may in part be due to increased sensitivity of current diagnostic criteria.

CLINICAL IMPLICATIONS: The new WASOG SAS determined that there were significant differences in the manifestations of American patients with sarcoidosis related to sex, race, and age.

DISCLOSURE: The following authors have nothing to disclose: Ying Zhou, Robert Baughman, Huiping Li, Elyse Lower

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