Clinical Characteristics of Patients in a Case Control Study of Sarcoidosis

Abstract

Sarcoidosis may be affected by sex, race, and age. A Case Control Etiologic Study of Sarcoidosis (ACCESS) enrolled 736 patients with sarcoidosis within 6 mo of diagnosis from 10 clinical centers in the United States. Using the ACCESS sarcoidosis assessment system, we determined organ involvement for the whole group and for subgroups differentiated by sex, race, and age (less than 40 yr or 40 yr and older). The study population was heterogeneous in terms of race (53% white, 44% black), sex (64% female, 36% male), and age (46% < 40 yr old, 54% > or = 40 yr old). Women were more likely to have eye and neurologic involvement (chi(2) = 4.74, p < 0.05 and chi(2) = 4.60, p < 0.05 respectively), have erythema nodosum (chi(2) = 7.28, p < 0.01), and to be age 40 yr or over (chi(2) = 6.07, p < 0.02) whereas men were more likely to be hypercalcemic (chi(2) = 7.38, p < 0.01). Black subjects were more likely to have skin involvement other than erythema nodosum (chi(2) = 5.47, p < 0.05), and eye (chi(2) = 13.8, p < 0.0001), liver (chi(2) = 23.3, p < 0.0001), bone marrow (chi(2) = 18.8, p < 0.001), and extrathoracic lymph node involvement (chi(2) = 7.21, p < 0.01). We conclude that the initial presentation of sarcoidosis is related to sex, race, and age.

Clinical characteristics and computed tomography findings in Arab patients diagnosed with pulmonary sarcoidosis

“…However, several investigators have identified older patients, with women tending to be of greater age than men 414. In the large “case control etiologic study of sarcoidosis” (ACCESS) study involving several geographic regions of the United States, women patients were generally older than men and one-third of patients were 60 years of age or over 2. In the present analysis, mean patient age at diagnosis was 49.3 years, consistent with earlier reports on Arab patients with sarcoidosis 68…”

Genome-wide search for sarcoidosis susceptibility genes in African Americans

“…We chose to focus on African Americans who are more commonly and severely affected, more likely to have a family history of sarcoidosis, affected at a younger age than Caucasians and less likely to be asymptomatic at presentation. 9,21,22 The Sarcoidosis Genetic Analysis Consortium (SAGA) was formed to ensure that a sufficient sample of affected sibling pairs could be recruited for study. We report the results of a sib pair linkage analysis of 380 microsatellite markers spanning the 22 autosomes in 229 AfricanAmerican families.…”

Hypercalcemia and soft tissue calcification owing to sarcoidosis: The sunlight-cola connection

“…Approximately 95% of patients have lung involvement, and skin, eye, and lymph nodes are also commonly involved. (1) Hypercalcemia is a well-described complication, occurring in 4% to 11% of patients. (1,2) Hypercalciuria is even more common than hypercalcemia, occurring in up to 40% of patients with sarcoidosis.…”

“…(1) Hypercalcemia is a well-described complication, occurring in 4% to 11% of patients. (1,2) Hypercalciuria is even more common than hypercalcemia, occurring in up to 40% of patients with sarcoidosis. (2) Hypercalcemia is caused by the increased conversion of 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D [1,25(OH) 2 D] by the enzyme 25-hydroxyvitamin-D-1a-hydroxylase (CYP27B1) in pulmonary alveolar macrophages.…”

“…(1,2) Hypercalciuria is even more common than hypercalcemia, occurring in up to 40% of patients with sarcoidosis. (2) Hypercalcemia is caused by the increased conversion of 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D [1,25(OH) 2 D] by the enzyme 25-hydroxyvitamin-D-1a-hydroxylase (CYP27B1) in pulmonary alveolar macrophages. Although sarcoidosis is more likely to occur in black patients, hypercalcemia is more likely to occur in white patients with sarcoidosis.…”