“Sarcoid like” granulomatous pulmonary disease in World Trade Center disaster responders

Crowley, Laura; Herbert, Robin; Moline, Jacqueline; Wallenstein, Sylvan; Shukla, Gauri; Schechter, Clyde B.; Skloot, Gwen; Udasin, Iris; Luft, Benjamin J.; Harrison, Denise; Shapiro, Moshe; Wong, K. O.; Sacks, Henry S.; Landrigan, Philip J.; Teirstein, Alvin S.

doi:10.1002/ajim.20924

Cited by 110 publications

(65 citation statements)

References 31 publications

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“…These studies do not account for reporting and detection biases inherent to the compensation and disability claims post-9/11. Similar findings were suggested by studies in two other cohorts, the WTC Registry and the NY/NJ WTC Responders [Jordan et al, 2008;Crowley et al, 2010]. The three studies have recruitment, surveillance, and reporting biases that make comparisons among them and to referent populations difficult but the consistency of their findings is impressive.…”

Section: Interstitial Pulmonary Diseasesupporting

confidence: 81%

The evolving spectrum of pulmonary disease in responders to the World Trade Center tragedy

Guidotti

Prezant

Hoz

et al. 2011

American J Industrial Med

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On September 11, 2001, events at the World Trade Center (WTC) exposed residents ofNew York City to WTC dust and products of combustion and pyrolysis. The majority ofWTC-exposed fire department rescue workers experienced a substantial decline in airflowover the first 12 months post-9/11, in addition to the normal age-related declinethat affected all responders, followed by a persistent plateau in pulmonary function inthe 6 years thereafter. The spectrum of the resulting pulmonary diseases consists ofchronic inflammation, characterized by airflow obstruction, and expressing itself indifferent ways in large and small airways. These conditions include irritant-inducedasthma, non-specific chronic bronchitis, aggravated pre-existing obstructive lung disease(asthma or COPD), and bronchiolitis. Conditions concomitant with airwaysobstruction, particularly chronic rhinosinusitis and upper airway disease, and gastroesophagealreflux, have been prominent in this population. Less common have beenreports of sarcoidosis or interstitial pulmonary fibrosis. Pulmonary fibrosis and bronchiolitisare generally characterized by long latency, relatively slow progression, and asilent period with respect to pulmonary function during its evolution. For these reasons,the incidence of these outcomes may be underestimated and may increase overtime. The spectrum of chronic obstructive airways disease is broad in this populationand may importantly include involvement at the bronchiolar level, manifested as smallairways disease. Protocols that go beyond conventional screening pulmonary functiontesting and imaging may be necessary to identify these diseases in order to understandthe underlying pathologic processes so that treatment can be most effective.

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Section: Interstitial Pulmonary Diseasesupporting

confidence: 81%

The evolving spectrum of pulmonary disease in responders to the World Trade Center tragedy

Guidotti

Prezant

Hoz

et al. 2011

American J Industrial Med

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“…No environmental or infectious antigens have been identified. 26,27 Sporadic cases of sarcoidosis have also been reported in World Trade Center rescuers, with exposed African Americans having twice the risk of developing pulmonary disease. 28 Among the many implicated infectious agents, scientific data involving mycobacteria has been the most compelling (Box 2).…”

Section: Etiopathogenesismentioning

confidence: 96%

Sarcoidosis

Sanchez

Haimovic

Prystowsky

2015

Dermatologic Clinics

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Sarcoidosis is a disease characterized by noncaseating granulomatous infiltration of 1 or more organs. In North America, after the lungs and thoracic lymph nodes, the skin is the next most commonly involved organ. Data from multiple studies indicate a coaction between genetic and environmental factors in immunologically susceptible hosts. The disease's many clinical manifestations and course vary greatly and are influenced by race, ethnicity, and gender. In the skin, the lesions of sarcoidosis are classified as specific when noncaseating granulomas are present, and nonspecific when there is an inflammatory reaction pattern devoid of granulomas.

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“…Other infectious agents that have been associated with sarcoidosis in previous reports include Proprionibacterium acnes, EpsteineBarr virus, and herpesvirus. 26 Reported noninfectious exposures associated with sarcoidosis have included World Trade Center disaster dust, 33 metals, combustible wood products, and moldy environments. 3,24,28,29 The initial step in the formation of a sarcoidal granuloma is the recognition and phagocytosis of a putative agent by an antigen-presenting cell (APC).…”

mentioning

confidence: 99%

Sarcoidosis: A comprehensive review and update for the dermatologist

Haimovic

Sanchez

Judson

et al. 2012

Journal of the American Academy of Dermatology

209

269

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“Sarcoid like” granulomatous pulmonary disease in World Trade Center disaster responders

Abstract: Sarcoid like granulomatous pulmonary disease is present among the WTC responders. While the incidence is lower than that reported among firefighters, it is higher than expected.

Cited by 110 publications

References 31 publications

The evolving spectrum of pulmonary disease in responders to the World Trade Center tragedy

The evolving spectrum of pulmonary disease in responders to the World Trade Center tragedy

Sarcoidosis

Sarcoidosis: A comprehensive review and update for the dermatologist

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