Sarcoidosis: the links between epidemiology and aetiology

Dubrey, Simon W; Shah, Shreena; Hardman, Timothy C.; Sharma, Rakesh

doi:10.1136/postgradmedj-2014-132584

Cited by 49 publications

(31 citation statements)

References 67 publications

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“…It has been well established that a number of metals can cause granulomatous inflammation as sarcoidosis and disease that mimics sarcoidosis, including beryllium, zirconium, titanium, nickel, chromium, cobalt, silicon, earth elements, and aluminum [8] [50–52]. Moreover, other studies report that man-made mineral fiber, hard rock dust (silica) and metal dust and silicates possess antigenic properties which promote granuloma formation [51].…”

Section: Discussionmentioning

confidence: 99%

Sarcoidosis in an Italian province. Prevalence and environmental risk factors

et al. 2017

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Background and aimSarcoidosis is a systemic granulomatous inflammatory disease whose causes are still unknown and for which epidemiological data are often discordant. The aim of our study is to investigate prevalence and spatial distribution of cases, and identify environmental exposures associated with sarcoidosis in an Italian province.MethodsAfter georeferentiation of cases, the area under study was subdivided with respect to Municipality and Health Districts and to the altitude in order to identify zonal differences in prevalence. The bioaccumulation levels of 12 metals in lichen tissues were analyzed, in order to determine sources of air pollution. Finally, the analysis of the correlation between metals and between pickup stations was performed.Results223 patients were identified (58.3% female and 41.7% male of total) and the mean age was 50.6±15.4 years (53.5±15.5 years for the females and 46.5±14.4 for the males). The mean prevalence was 49 per 100.000 individuals. However, we observed very heterogeneous prevalence in the area under study. The correlations among metals revealed different deposition patterns in lowland area respect to hilly and mountain areas.ConclusionsThe study highlights a high prevalence of sarcoidosis cases, characterized by a very inhomogeneous and patchy distribution with phenomena of local aggregation. Moreover, the bioaccumulation analysis was an effective method to identify the mineral particles that mostly contribute to air pollution in the different areas, but it was not sufficient to establish a clear correlation between the onset of sarcoidosis and environmental risk factors.

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Section: Discussionmentioning

confidence: 99%

Sarcoidosis in an Italian province. Prevalence and environmental risk factors

et al. 2017

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“…Initial chest x-ray revealed more advanced disease in HLA-DRB1*014 and HLA-DRB1*015 positive patients. Previous studies revealed that HLA-DRB allels played a crucial role for many aspects of sarcoidosis [9,10,[17][18][19][20]. Prognosis and outcome of sarcoidosis predominantly depends upon the specific HLA profile of the patient.…”

Section: Discussionmentioning

confidence: 99%

Association of HLA antigens with the clinical course of sarcoidosis and familial disease

Yanardağ

Tetikkurt

Bilir

et al. 2017

Monaldi Arch Chest Dis

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Patients with sarcoidosis usually have a benign course and a favourable prognosis. Although spontaneous remission is common, a progressive disease with a severe prognosis occurs in a small but significant number of patients. The aim of this study was to evaluate the potential significance of HLA antigens as a clinical marker on the outcome of sarcoidosis patients. We conducted a retrospective cohort study for HLA class I and II allels in 74 sarcoidosis patients and 72 healthy transplant donors. Bronchoscopy and bronchial biopsies were performed in each patient.

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“…Published incidence and prevalence rates of sarcoidosis in non-WTC-exposed populations, which are often used as comparison rates for WTC-exposed, are highly variable and population dependent, based on race/ethnicity, geography,[6, 7] socioeconomic status and access to healthcare. [8] The access to care issue is of particular importance in sarcoidosis as a substantial proportion of cases (30–50% by various estimates) are asymptomatic,[9] of which a significant proportion resolve spontaneously over time, leading to an unknown amount of undetected and unreported disease. Second, rates from different populations can only be meaningfully compared when cases have been collected in the same way, i.e., when the method of case ascertainment is similar across groups.…”

Section: Introductionmentioning

confidence: 99%

Post-9/11 sarcoidosis in WTC-exposed firefighters and emergency medical service workers

Webber

Yip

Zeig‐Owens

et al. 2017

Respiratory Medicine

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Introduction The World Trade Center (WTC) disaster released a huge quantity and variety of toxicants into the environment. To-date, studies from each of the three major cohorts of WTC-exposed workers have suggested “greater than expected” numbers of post-9/11 cases in some workers. We undertook this study to estimate the incidence of post-9/11 sarcoidosis in ~13,000 male firefighters and EMS workers enrolled in The Fire Department of the City of New York (FDNY) WTC Health Program; to compare FDNY incidence to rates from unexposed, demographically similar men in the Rochester Epidemiology Project (REP); and, to examine rates by level of WTC exposure. Methods We calculated incidence of sarcoidosis diagnosed from 9/12/2001 to 9/11/2015, and generated expected sex- and age-specific rates based on REP rates. Standardized incidence ratios (SIR) based on REP rates, and 95% confidence intervals (95% CI) were estimated. Two sensitivity analyses limited cases to those with intra-thoracic symptoms or biopsy confirmation. Results We identified 68 post-9/11 cases in the FDNY cohort. Overall, FDNY rates were significantly higher than expected rates (SIR= 2.8; 95% CI= 2.2, 3.6). Including only symptomatic cases, the SIR decreased (SIR= 2.2; 95% CI=1.5, 3.0), but remained significantly elevated. SIRs ranged from 2.7 (95% CI=2.0, 3.5) in the lower WTC exposure group to 4.2 (95% CI=1.9, 8.0) in the most highly exposed. Conclusions We found excess incident post-9/11 sarcoidosis in WTC-exposed workers. Continued surveillance, particularly of those most highly exposed, is necessary to identify those with sarcoidosis and to follow them for possible adverse effects including functional impairments and organ damage.

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Sarcoidosis: the links between epidemiology and aetiology

Cited by 49 publications

References 67 publications

Sarcoidosis in an Italian province. Prevalence and environmental risk factors

Sarcoidosis in an Italian province. Prevalence and environmental risk factors

Association of HLA antigens with the clinical course of sarcoidosis and familial disease

Post-9/11 sarcoidosis in WTC-exposed firefighters and emergency medical service workers

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